川崎病并发冠状动脉损害危险因素的探讨

Risk factors of complicated coronary artery lesion in Kawasaki disease

目的:探究川崎病(KD)并发冠状动脉损害(CAL)的危险因素。方法:选择2016年2月-2018年11月于天津医科大学总医院住院治疗的91例川崎病患儿的临床资料为研究对象,并按照超声心动图结果将其分为CAL组(KD并发CAL,n=23)和NCAL组(KD未并发CAL,n=68)。将两组的性别、年龄、主要诊断、发热持续时间、血红蛋白(HB)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、血小板/中性粒细胞比值(PNR)、血钠、总蛋白、白蛋白、谷草转氨酶、谷丙转氨酶、血沉(ESR)、C反应蛋白(CRP)、降钙素原(PCT)、N端脑钠肽前体(NT-proBNP)、静脉注射用免疫球蛋白(IVIG)及阿司匹林的初始治疗、是否应用激素进行单因素分析及二元Logistic回归分析。结果:两组患儿年龄、PLR、HB、PCT、ESR、IVIG无反应的发生,差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,年龄、PLR及HB是川崎病并发冠状动脉扩张的危险因素(P<0.05)。结论:患儿年龄小、PLR升高及HB降低是KD并发CAL的独立危险因素。

Objective:To investigate the risk factors of complicated coronary artery lesion(CAL)in Kawasaki disease(KD).Methods:The clinical data of 91 patients with Kawasaki disease who were hospitalized at the General Hospital of Tianjin Medical University from February 2016 to November 2018 were selected as the subjects,and they were divided into CAL group(KD complicated CAL,n=23)and NCAL group(KD not complicated CAL,n=68)according to echocardiogram results.Their gender,age,main diagnosis,duration of fever,Hemoglobin(HB),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),platelet-to-neutrophil ratio(PNR),blood Sodium,Total protein,Albumin,Aspartate aminotransferase,Alanine aminotransferase,Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),Procalcitonin(PCT),N-terminal pro-brain natriuretic peptide(NT-proBNP),the initial treatment of Intravenous immune globulin(IVIG)and aspirin,Whether hormone was used were compared between the two groups by single factor analysis and binary logistic regression analysis.Results:There were significant differences in age,PLR,HB,PCT,ESR and the occurrence of non-reactivity of IVIG between the two groups(P<0.05).The results of binary logistic regression analysis showed that age,PLR,and HB are risk factors of complicated CAL in KD(P<0.05).Conclusion:Younger,increased PLR and decreased HB were independent risk factors of complicated coronary artery lesion in Kawasaki disease.