儿童病毒感染与川崎病发病及冠状动脉病变的相关性

Relationship between virus infection in children with Kawasaki disease and coronary artery disease

目的探究病毒感染与川崎病(KD)发病及冠状动脉病变的相关性。方法选取KD儿童105例为KD组,同期选取发热性疾病但非KD患儿210例为非KD组。对两组患儿的病毒感染情况进行比较,并行超声心动图检查,比较两组儿童冠状动脉病变情况。结果两组患儿中病毒感染232例,其中,KD组感染96例,占91.43%,非KD组感染136例,占64.76%。两组EB病毒感染率比较,KD组患儿明显高于非KD组患儿,差异具有统计学意义(χ2=32.874,P<0.001);呼吸道合胞病毒、副流感病毒、流感病毒、腺病毒、单纯疱疹病毒、冠状病毒感染率两组比较,差异均无统计学差异(均P>0.05)。分别将KD组和非KD组分为感染组与未感染组,其中KD组中感染组患儿冠状动脉损伤率最高,为46.55%(43/96),显著高于KD组的未感染组(11.11%),差异均具有统计学意义(确切概率法得出P=0.04),亦高于非KD组的感染组(7.59%)和未感染组(8.22%),差异均具有统计学意义(χ2值分别为42.45、27.41,均P<0.001);而KD组中未感染组(11.11%)、非KD组的感染组(7.95%)和未感染组(8.11%)比较差异无统计学意义(P>0.05)。结论患儿病毒感染与KD发病有关,且病毒感染的KD患儿更易发生冠状动脉病变。

Objective To investigate the relationship between virus infection in children with Kawasaki disease（ KD） and coronary artery disease. Methods Totally 105 cases of children with KD were selected in KD group,and 210 children with febrile disease but without KD were chosen in non-KD group. The status of virus infection and coronary artery injury were compared between two groups by ultrasonic cardiogram examination. Results There were 232 cases with virus infection,including 96 cases（ 91. 43%） in KD group and 136 cases（ 64. 76%） in non-KD group. EB virus infection rate in KD group was significantly higher than in non-KD group,and the difference was statistically significant（ χ2= 32. 874,P〈 0. 001）. The infection rate of RS virus,parainfluenza virus,influenza virus,adenovirus,fever blisters virus and coronavirus was not significantly different between two groups（ all P〉 0. 05）. Both KD group and non-KD group were divided into infection group and non-infection group. The coronary artery injury rate was highest in infection group of KD group（ 46. 55%,43 /96）,which was higher than that in non-infection group（ 11. 11%）,and the difference was statistically significant（ P = 0. 04）. It was also higher than that in infection group of non-KD group（ 7. 59%） and non-infection group（ 8. 22%）,and the difference was significant（ χ2value was 42. 45 and 27. 41,respectively,both P〈 0. 001）. However,the difference was not statistically significant among noninfection group of KD group（ 11. 11%）,infection group（ 7. 85%） and non-infection group（ 8. 11%） of non-KD group（ P〉 0. 05）.Conclusion KD may be correlated with virus infection,and infected children are more likely to suffer coronary artery injury.