动态心电图检查及中性粒细胞与淋巴细胞比值在小儿川崎病合并冠状动脉改变的临床价值

The clinical value of dynamic electrocardiogram and the NLR in the diagnosis on Kawasaki disease combined with changes of coronary artery for children

目的:探究动态心电图检查及中性粒细胞与淋巴细胞比值在小儿川崎病合并冠状动脉改变的临床诊断价值。方法:选取80例川崎病患儿,根据合并冠状动脉病变情况,将合并冠状动脉病变的患儿分为观察组(48例),未合并冠状动脉病变的患儿分为对照组(32例)。对所有患儿均于发病15 d内行动态心电图及常规心电图监测、超声心动图扫描以及血常规检测,记录并分析所有患儿中性粒细胞与淋巴细胞量及动态心电图变化情况;比较两组患儿中性粒细胞和淋巴细胞量及中性粒细胞与淋巴细胞比值(NLR)。结果:观察组发生窦性心律过速、房室传导阻滞、平均心率异常和总异常人数比例与对照组相比显著增加,两组患儿动态心电图异常总数比较差异有统计学意义(x^2=20.112,P<0.05);动态心电图对川崎病合并冠状动脉异常显著高于常规心电图,其差异有统计学意义(x^2=17.778,P<0.05);观察组与对照组相比,冠状动脉扩张程度越大,患儿中性粒细胞数量越多,两组比较差异有统计学意义(t=-3.464,P<0.05);且观察组轻度扩张患儿与对照组NLR值相比,差异有统计学意义(t=2.976,P<0.05)。结论:动态心电图检查及中性粒细胞与淋巴细胞比值对小儿川崎病合并冠状动脉改变诊断中存在重要意义。

Objective:To investigate the clinical value of ambulatory electrocardiogram and the neutrophils to lymphocytes ratio(NLR)in the diagnosis on Kawasaki disease combined with changes of coronary artery for children.Methods:80children with Kawasaki disease were enrolled in the research.According to the combined situation of coronary artery disease,all of children with combined coronary artery disease were divided in observation group(48cases)and the children without combined coronary artery disease were divided in control group(32cases).All of children received the examinations of dynamic electrocardiogram,routine electrocardiogram,ultrasound cardiogram scan and blood routine detection within15d of occurring disease.And the amounts of neutrophil and lymphocyte,and change of dynamic electrocardiogram of all of children were recorded and analyzed.And then the amounts of neutrophil and lymphocyte and the NLR of the two groups were further compared.Results:The sinus tachycardia,atrioventricular block,abnormal average heart rate and the proportions of total abnormal number of observation group were significantly higher than that of control group,and the difference of total number of ambulatory electrocardiographic abnormality between the two groups were significant(x2=20.112,P<0.05).The results of ambulatory electrocardiogram for Kawasaki disease combined with abnormal coronary artery were significantly higher than that of control group(x2=17.778,P<0.05).Compared with control group,the coronary artery ectasia was more larger,the amount of neutrophils would be more greater in observation group,and the difference between the two groups was significant(t=-3.464,P<0.05).Besides,the difference of NLR between patients with mild ectasia of observation group and patients of control group was significantly(t=2.976,P<0.05).Conclusion:Dynamic electrocardiogram and the NLR have important significance in the diagnosis for children with Kawasaki disease combined with the change of coronary artery.