肺炎支原体感染对川崎病患儿心血管损伤特点分析

Characteristics of cardiovascular lesion caused by Mycoplasma pneumoniae infection in children with Kawasaki disease

目的分析肺炎支原体(MP)感染对川崎病(KD)患儿心血管损伤的特点,为临床诊治提供指导。方法回顾性分析2018年1月—2021年3月收治于某三级综合医院小儿心血管科的KD患儿临床资料,根据MP感染情况分为KD合并MP感染组(KD-MP组)和KD未合并MP感染组(KD组),比较两组患儿血小板参数、凝血相关指标、心肌酶谱及不良结局发生率的差异。结果共纳入270例KD患儿,其中KD-MP组70例,KD组200例。KD-MP组平均血小板体积(MPV)中位水平[10.00(9.08,11.00)fL]较KD组[9.60(8.83,10.68)fL]更高,差异有统计学意义(P<0.05)。KD-MP组冠状动脉损伤(CAL)、冠状动脉轻度扩张、心包积液的占比分别为55.71%、47.14%、15.71%,高于KD组的38.50%、30.50%、5.50%,差异均有统计学意义(均P<0.05)。结论合并MP感染的KD患儿更易并发CAL和心包积液,面临更大的心血管损伤风险,临床医生应及时采取抗感染治疗。

Objective To analyze the characteristics of cardiovascular lesion caused by Mycoplasma pneumoniae(MP)infection in children with Kawasaki disease(KD),and provide guidance for clinical diagnosis and treatment.Methods Clinical data of children with KD who were admitted to the department of pediatric cardiology of a tertiary general hospital from January 2018 to March 2021 were analyzed retrospectively,patients were divided into KD complicated with MP infection group(KD-MP group)and KD without MP infection group(KD group),differences in platelet parameters,coagulation-related indexes,myocardial enzyme spectrum and incidence of adverse outcomes between two groups of children were compared.Results A total of 270 children with KD were included in analysis,including 70 cases in KD-MP group and 200 cases in KD group.The median level of mean platelet volume(MPV)in KD-MP group was higher than that in KD group(10.00[9.08,11.00]fL vs 9.60[8.83,10.68]fL,P<0.05).The proportions of coronary artery lesion,mild coronary artery dilatation and pericardial effusion in KD-MP group were 55.71%,47.14%and 15.71%respectively,which were higher than 38.50%,30.50%and 5.50%in KD group(all P<0.05).Conclusion KD patients complicated with MP infection are more likely to suffer from coronary artery lesion and pericardial effusion,and face a greater risk of cardiovascular lesion,clinicians should take anti-infective treatment in time.