不同炎性指标检测在川崎病患儿诊断中的价值

The value of different inflammatory indicators in children with Kawasaki disease

目的分析川崎病患儿血常规白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)、血沉(ESR)结果,探讨其对川崎病的诊断及预测合并冠状动脉损害的价值。方法选择2018年7-12月中国科学技术大学附属第一医院儿科收治的56例川崎病患儿作为川崎病组,依据超声心动图结果,将川崎病患儿分为冠状动脉损害组(CAL组,25例)与无冠状动脉损害组(NCAL组,31例);选取40例同期间发热5~7 d的肺炎住院患儿作为感染组;另选择同期进行健康体检的32例正常儿童作为对照组。分别采用全自动白细胞计数法、免疫荧光干式定量法、魏氏法,检测各组WBC、CRP、PCT、ESR水平,分析上述指标与CAL的关系。结果川崎病组患儿的WBC、CRP、PCT及ESR水平均明显高于感染组和对照组[WBC(×10~9/L):19.22±6.43 vs. 10.89±4.56、8.48±2.15,CRP(mg/L):100.29±75.86 vs. 17.03±18.79、3.94±1.91,PCT(g/L):3.22±6.83 vs. 0.69±1.06、0.14±0.25,ESR(mm/h):73.36±28.57 vs. 27.45±13.37、8.59±4.32,均P<0.05];CAL组患儿WBC、CRP、PCT、ESR水平均明显高于NCAL组[WBC(×10~9/L):23.26±6.19 vs. 15.96±4.53,CRP(mg/L):161.11±73.15 vs. 51.24±26.45,PCT(g/L):5.59±9.54 vs. 1.30±2.06,ESR(mm/h):95.20±23.23 vs. 55.74±18.62,均P<0.05]。结论血WBC、CRP、PCT及ESR早期升高与川崎病密切相关,检测该炎症指标水平对预测CAL有重要价值,对临床早期治疗及预后评估具有重要指导作用。

Objective To analysis the results of white blood cell count(WBC), C-reactive protein(CRP), procalcitonin(PCT) and erythrocyte sedimentation rate(ESR) in children with Kawasaki disease(KD), and to explore its value in diagnosis of KD and prediction of KD with coronary artery injury(CAL) damage. Methods From July to December 2018, 56 children with KD in our Hospital were selected as KD group, including 31 children with coronary artery lesion(CAL) and 25 children with non coronary artery lesion(NCAL). Children with pneumonia who had a fever for 5-7 days in the same period were selected as the infection group(40 cases), and 32 healthy children received health screening were selected as the health group. The levels of WBC, CRP, PCT and ESR were measured by automatic white blood cell count、immunofluorescence dry quantitative method and Westergren, respectively. The relationships between those indicators and CAL were analyzed. Results The levels of WBC, CRP, PCT and ESR in children of KD group were significantly higher than those in infection group and health group [WBC(×10~9/L): 19.22±6.43 vs. 10.89±4.56, 8.48±2.15;CRP(mg/L): 100.29±75.86 vs. 17.03±18.79, 3.94±1.91;PCT(g/L): 3.22±6.83 vs. 0.69±1.06, 0.14±0.25;ESR(mm/h): 73.36±28.57 vs. 27.45±13.37, 8.59±4.32, all P<0.05]. The levels of WBC, CRP, PCT and ESR in CAL group were significantly higher than those in NCAL group [WBC(×10~9/L): 23.26±6.19 vs. 15.96±4.53;CRP(mg/L): 161.11±73.15 vs. 51.24±26.45;PCT(g/L): 5.59±9.54 vs. 1.30±2.06;ESR(mm/h): 95.20±23.23 vs. 55.74±18.62, all P<0.05]. Conclusion The early elevation of WBC, CRP, PCT and ESR are closely related to KD. The detections of those inflammatory indicators are of important value for predicting CAL, and have great guiding role in early clinical treatment and prognosis evaluation.