人巨细胞病毒感染与川崎病的相关性

Correlation between human cytomegalovirus infection and Kawasaki disease

目的:分析川崎病(KD)儿童血清中人巨细胞病毒(HCMV)抗体水平与KD发生及临床特征的相关性。方法:收集2005年3月至2013年12月温州医科大学附属第二医院育英儿童医院收治的233例KD儿童、113例健康体检儿童及143例发热儿童临床数据进行回顾性分析,同时收集58例KD儿童、40例健康体检儿童及40例发热儿童血清标本行HCMV抗体检测,验证回顾性分析的结果。综合分析KD儿童临床特征、血液指标与HCMV感染之间的关系。结果:回顾性分析结果显示,KD儿童与正常儿童血清HCMVIgM阳性率差异无统计学意义(P>0.05),但均低于发热儿童(P<0.05)。另外,KD儿童、发热儿童及正常儿童血清HCMV IgG阳性率以及滴度水平差异无统计学意义(P>0.05)。验证分析结果显示,3组儿童血清HCMV IgM、IgG阳性率以及IgM滴度水平差异无统计学意义(P>0.05),但KD儿童血清HCMV IgG滴度水平高于发热儿童与正常儿童(P<0.05)。KD儿童临床指标和HCMV感染的相关分析显示,HCMV IgM阳性KD儿童冠状动脉损害的发生比例高于阴性儿童(P<0.05);HCMVIgG阳性和阴性KD儿童冠状动脉损害差异无统计学意义(P>0.05)。结论:HCMV感染与KD的发生可能无相关性,但在KD儿童中,HCMV的急性感染可能与冠状动脉损害相关。

Objective： To investigate the human cytomegalovirus（HCMV） antibody levels in peripheral blood in children with Kawasaki disease（KD） and its correlation with the clinical characteristics of KD. Methods：Two hundred and thirty three children with KD, 113 healthy children and 143 children with fever were collected for retrospective analysis from the Second Affliated Hospital Yuying Children＇s Hospital of Wenzhou Medical University from March 2005 to December 2013. Then 58 KD children, 40 healthy children and40 children with fever were collected for verification analysis. The relationship between clinical characteristics,laboratory indexes and HCMV infection in KD children was analyzed. Results： Retrospective analysis showed that the HCMV IgM positive rate of KD children was lower than fever children（P〉0.05）, but had no statistical difference from healthy children（P〈0.05）. The HCMV IgM positive rate of healthy children was also lower than fever children（P〉0.05）. And there were no statistical difference in IgG positive rate, IgM and IgG antibody titer level among three groups. The verification analysis found that IgM, IgG positive rate and IgM antibody titer level were not statistically different among three groups（P〉0.05）. But the IgG antibody titer level of KD children was higher than healthy children and fever children（P〈0.05）. The realation between HCMV infection and clinical features of KD children showed that the incidence of coronary artery injury in HCMV IgM positive children with KD was obviously higher than that of HCMV IgM negative children（P〈0.05）. There was no difference in the incidence of coronary artery injury in children with HCMV IgG positive and HCMV IgG negative. Conclusion：There is no correlation between HCMV infection and the occurrence of KD. However, HCMV infection may be associated with the progression of coronary artery lesion in KD children.