C-反应蛋白和红细胞分布宽度与川崎病患儿并发冠脉损伤的关系

Relationship between C-reactive protein,red blood cell distribution width and coronary artery injury in children with Kawasaki disease

目的:探讨C-反应蛋白(CRP)和红细胞分布宽度(RDW)与川崎病(KD)患儿并发冠脉损伤(CAL)的关系。方法:选取96例KD患儿为研究对象,依据心脏超声检查结果分为CAL组(合并CAL,n=38)和KD组(不合并CAL,n=58)。比较两组患儿血清CRP和RDW水平,分析其与KD患儿合并CAL的关系。结果:CAL组患儿年龄小于KD组(P<0.05),发热病程、白细胞计数、CRP和RDW均高于KD组(P<0.05);发热病程(OR=1.080)、白细胞计数(OR=1.432)、CRP(OR=1.106)和RDW(OR=2.726)均是KD患儿并发CAL的影响因素(P<0.05);CRP、RDW及二者联合预测KD患儿并发CAL的曲线下面积(AUC)分别为0.727、0.812和0.891,二者联合的AUC高于单独CRP或RDW(P<0.05)。结论:CRP和RDW偏高是KD患儿并发CAL的独立危险因素,二者联合检测对早期预测KD患儿并发CAL有重要价值。

Objective:To investigate the relationship between C-reactive protein(CRP),red blood cell distribution width(RDW)and coronary artery injuries(CAL)in children with Kawasaki disease(KD).Methods:96 children with KD were selected.According to the results of cardiac ultrasound,38 cases with CAL were recorded as CAL group,and 58 cases without CAL were recorded as KD group.The levels of serum CRP and RDW between the two groups were compared,and the relationship between them and CAL in children with KD was analyzed.Results:The age of CAL group was younger than that of KD group(P<0.05),and the course of fever,leukocyte count,CRP and RDW were higher than those of KD group(P<0.05).The course of fever(OR=1.080),leukocyte count(OR=1.432),CRP(OR=1.106)and RDW(OR=2.726)were the influencing factors of CAL in children with KD(P<0.05).The area under curve(AUC)of CRP,RDW and their combination in predicting CAL in children with KD were 0.727,0.812 and 0.891,respectively.The AUC of the combination of CRP and RDW was higher than that of CRP or RDW alone(P<0.05).Conclusion:High CRP and RDW are independent risk factors for concurrent CAL in children with KD.The combined detection of CRP and RDW is of great value in early prediction of concurrent CAL in children with KD.