川崎病合并肺炎支原体感染患儿血清炎症因子水平的变化及其对冠状动脉损害的影响

Changes of Serum Inflammatory Factors in Children with Kawasaki Disease Complicated with Mycoplasma Pneumoniae Infection and Its Influence on Coronary Artery Damage

目的:探讨川崎病合并肺炎支原体感染患儿血清炎症因子水平的变化及其对冠状动脉损害的影响。方法:回顾性分析2017年1月-2020年1月本医院进行就诊、确诊并住院治疗的120例川崎病患儿的临床资料,按照患儿是否合并有肺炎支原体感染将其为感染组(n=43)和非感染组(n=77)。比较两组的临床特征指标、血清炎症因子指标(IL-6、IL-8、IL-10、TNF-α)、心肌酶谱指标(AST、CK、CK-MB、LDH)、冠状动脉损害情况。结果:两组性别、年龄、中性粒细胞计数、淋巴细胞计数、白蛋白、C反应蛋白、谷丙转氨酶、主要症状以及发热天数比较,差异均无统计学意义(P>0.05)。感染组白细胞计数和血小板计数均高于未感染组,差异均有统计学意义(P<0.05)。感染组IL-6、IL-8、IL-10、TNF-α、AST、CK、CK-MB、LDH水平均高于非感染组,差异均有统计学意义(P<0.05)。两组均无冠状动脉闭塞。两组冠状动脉扩张、冠状动脉瘤、冠状动脉狭窄发生率比较,差异均无统计学意义(P>0.05)。感染组冠状动脉损害发生率高于非感染组,差异有统计学意义(P<0.05)。结论:肺炎支原体感染患者的血清炎症因子及心肌酶谱指标水平均升高,造成心肌损害,增加了冠状动脉的损害情况,需要临床加以重视,及早发现、及早治疗,避免造成患者的冠状动脉损害。

Objective:To investigate the changes of serum inflammatory factors in children with Kawasaki disease complicated with Mycoplasma pneumoniae infection and its influence on coronary artery damage.Method:The clinical data of 120 children with Kawasaki disease who were admitted,diagnosed and hospitalized in our hospital from January 2017 to January 2020 were retrospectively analyzed.The children were divided into infection group(n=43)and non-infection group(n=77)according to whether they were complicated with mycoplasma pneumoniae infection.Clinical characteristics,serum inflammatory factors(IL-6,IL-8,IL-10,TNF-α),myocardial enzymes(AST,CK,CK-MB,LDH)and coronary artery damage were compared between two groups.Result:There were no significant differences in gender,age,neutrophil count,lymphocyte count,albumin,C-reactive protein,glutamic-pyruvic transaminase,main symptoms and fever days between two groups(P>0.05).The WBC count and platelet count in the infection group were higher than those in the non-infection group,the differences were statistically significant(P<0.05).The levels of IL-6,IL-8,IL-10,TNF-α,AST,CK,CK-MB and LDH in the infection group were higher than those in the non-infection group,the differences were statistically significant(P<0.05).There was no coronary artery occlusion in both groups.Comparison of incidences of coronary artery dilatation,coronary aneurysm,coronary artery stenosis between the two group,the differences were not statistically significant(P>0.05).The incidence of coronary artery damage in the infection group was higher than that in the non-infection group,and the difference was statistically significant(P<0.05).Conclusion:The levels of serum inflammatory factors and myocardial enzyme spectrum in patients with mycoplasma pneumoniae infection increased,resulting in myocardial enzymes and increased coronary artery damage.Clinical attention should be paid to early detection and treatment to avoid coronary artery damage in patients.