肺炎支原体感染与川崎病及冠状动脉病变的关系

Study on relationship between Mycoplasma pneumoniae infection and Kawasaki disease and coronary artery

目的探讨肺炎支原体感染和川崎病及冠状动脉病变之间的关系。方法选择在我院接受治疗的180例川崎病患儿作为观察组,选择同期在我院接受治疗的排除肺部疾病、出疹性疾病的患儿作为对照组。对观察组外周血使用间接免疫荧光法检测肺炎支原体抗体IgM(MP-IgM)阳性与否,使用被动凝集法检测肺炎支原体总抗体;根据其是否受到肺炎支原体的感染将观察组分为感染组和非感染组,比较两组静脉用丙种球蛋白(IVIG)治疗前后外周血白细胞、血小板、C反应蛋白中性粒细胞数量,血沉、冠状动脉病变发生率以及住院时间;根据是否发生冠状动脉病变将观察组分为冠状动脉病变组与非冠状动脉病变组,比较两组肺炎支原体的感染率。结果观察组肺炎支原体感染率明显高于对照组(P<0.05);感染组C反应蛋白、中性粒细胞数量,血沉、冠状动脉扩张病变发生率与非感染组比较差异有统计学意义(P<0.05);冠状动脉病变组肺炎支原体感染率明显高于非冠状动脉病变组(P<0.05)。结论川崎病的发病可能与肺炎支原体的感染有关,而且感染对冠状动脉病变的发生也具有一定的影响作用。

Objective To explore the relationship between pneumonia mycoplasma infection and Kawasaki disease and coronary artery lesions.Methods A total of 180 children with Kawasaki disease were chosen as research group,the chidren with rash disease during the same period excluding lung disease were selected as control group.In research group,MP-IgM was detected from peripheral blood by indirect immunofluorescence method,Mycoplasma pneumoniatotal antibody was detected by passive agglutination method;According to whether the children was infected with Mycoplasma pneumoniae,the research group was separated into infection group and non-infection group.Before and after gamma globulin（IVIG）treatment,comparison was made in peripheral blood leukocytes,platelets,C-reactive protein,number of neutrophils,blood sedimentation,the incidence of coronary artery lesions and the hospital stay;According to whether the occurrence of coronary artery lesions,the research group was divided into coronary artery lesions group and non-coronary artery lesions group,and the incidence of Mycoplasma pneumoniae infection was compared.Results Mycoplasma pneumoniae infection rate was significantly higher in research group than in control group（P〈0.05）;The incidences of C-reactive protein,number of neutrophils,blood sedimentation,expansion of coronary artery disease was significantly different between infection group and non-infection group（P〈0.05）;The incidence of Mycoplasma pneumoniae infection was significantly higher in coronary artery lesions group than in non-coronary artery lesions group（P〈0.05）.Conclusion The pathogenesis of Kawasaki disease may be associated with the infection of Mycoplasma pneumoniae,and the infection also has certain impact on the occurrence of coronary artery lesions.