川崎病合并低蛋白血症105例临床分析

Clinical analysis of 105 cases of Kawasaki disease complicated by hypoproteinemia

目的分析川崎病合并低蛋白血症患儿的临床特点。方法回顾分析吉安市中心人民医院2015年1月至2019年12月收治的川崎病患儿105例的临床资料。根据血清白蛋白(ALB)浓度分为正常白蛋白组(ALB ≥ 35 g/L)(54例)和低白蛋白血症组(ALB < 35 g/L)(51例), 比较两组白细胞(WBC)、血红蛋白(Hb)、C反应蛋白(CRP)、红细胞沉降率(ESR)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆汁酸(TBA)、冠状动脉B超检查等。结果各年龄段低蛋白血症发生率相似。两组冠状动脉扩张率比较, 差异有统计学意义(χ^(2)=5.49, P < 0.05);两组手足硬肿、尿蛋白阳性率差异均无统计学意义(χ^(2)=0.40、0.39, 均P > 0.05);低ALB组的 WBC(15.2×10^(9)/L)、ESR[(82.1±26.1)mm/h]、CRP(94.7 mg/L]均高于正常ALB组[11.5×10^(9)/L、(54.5±26.2)mm/h、43.65 mg/L](Z=-2.94、t=5.40、Z=-6.01, 均P < 0.01), 两组ALT、AST、TBA等差异均无统计学意义(均P > 0.05)。结论川崎病合并低蛋白血症的发生率与年龄无相关性, 与炎性反应有关;低蛋白血症是冠状动脉扩张的危险因素。该研究具有显著科学性。

Objective To analyze the clinical characteristics of children with Kawasaki disease complicated by hypoproteinemia.Methods The clinical data of 105 children patients with Kawasaki disease who received treatment in Ji'an Central People's Hospital,China between January 2015 and December 2019 were retrospectively analyzed.These patients were divided into normal-level albumin(ALB)group(≥35 g/L,n=54)and low-level ALB group(<35 g/L,n=51).White blood cell count,hemoglobin,C-reactive protein,erythrocyte sedimentation rate,alanine aminotransferase,aspartate aminotransferase,total bile acid,and coronary artery B-ultrasound examination results were compared between the two groups.Results The incidence of hypoproteinemia was similar among all age groups.There was significant difference in coronary artery dilatation rate between the two groups(χ^(2)=5.49,P<0.05).There were no significant differences in the percentage of patients with hand and foot scleredema and urinary protein-positive rate between the two groups(χ^(2)=0.40,0.39,both P>0.05).White blood cell count,erythrocyte sedimentation rate,C-reactive protein level in the low-level ALB group were 15.2×10^(9)/L,(82.1±26.1)mm/h,94.7 mg/L,respectively,which were significantly higher than those in the normal-level ALB group[11.5×10^(9)/L,(54.5±26.2)mm/h,43.65 mg/L,Z=-2.94,t=5.40,Z=-6.01,all P<0.01].There were no significant differences in alanine aminotransferase,aspartate aminotransferase,and total bile acid levels between the two groups(all P>0.05).Conclusion The incidence of Kawasaki disease complicated by hypoproteinemia is unrelated to age and it is related to inflammatory reaction.Hypoproteinemia is a risk factor of coronary artery dilatation.This study is of great science.