不同年龄段川崎病的临床特征与冠状动脉损伤的关系

Relationship between Clinical Characteristics of Kawasaki Disease and Coronary Artery Lesions in Different Age Groups

目的探讨不同年龄段川崎病(Kawasaki disease,KD)患儿的临床特征与冠状动脉损伤(coronary artery lesions,CAL)的关系。方法回顾性收集2014年1月~2021年2月西南医科大学附属医院收治的507例KD患儿的临床资料,将其分为<4岁组、4~6岁组和≥6岁组,并分别进行分析。结果<4岁组中发生CAL患儿的发热时间较非冠状动脉损伤(non-coronary artery lesion,NCAL)长,4~6岁组中颈部淋巴结肿大的出现与CAL呈负相关(P<0.05)。在静脉注射丙种球蛋白(intravenous immunoglobulin,IVIG)治疗前,<4岁组中发生CAL患儿的白细胞计数(white blood cell,WBC)、中性粒细胞计数(neutrophil,NEU)、血小板平均体积(mean platelet volume,MPV)均高于NCAL,<4岁组和4~6岁组中CAL患儿的白蛋白(albumin,ALB)水平均低于NCAL(P<0.05);≥6岁组中CAL患儿的球蛋白(globin,GLO)水平低于NCAL,白蛋白与球蛋白比值(albumin/globin,A/G)是≥6岁组KD患儿发生CAL的危险因素(P<0.05)。<4岁组中IVIG治疗前WBC>18.02×10^(9)/L(OR=2.861,95%CI:1.750~4.678)、MPV>9.15fl(OR=2.138,95%CI:1.294~3.531)、ALB<36.65g/L(OR=2.336,95%CI:1.369~3.987)是预测KD患儿发生CAL的独立危险因素(P<0.05)。结论分年龄段分析KD患儿的临床特征有助于更加个体化预测CAL的发生。

Objective To explore the relationship between the clinical characteristics of Kawasaki disease(KD)and coronary artery lesions(CAL)in different age groups.Methods The clinical data of 507 children with KD admitted to the Affiliated Hospital of Southwest Medical University from January 2014 to February 2021 were retrospectively collected,they were divided into<4 years old group,4-6 years old group,and≥6 years old group,and the relevant indicators were analyzed.Results The fever time of CAL in<4 years old group was longer than that of NCAL,and the cervical lymphadenectasis was negatively correlated with CAL in 4-6 years old group(P<0.05).Before intravenous immunoglobulin(IVIG)treatment,white blood cell(WBC),neutrophil(NEU)and mean platelet volume(MPV)of CAL were higher than those of NCAL in<4 years old group,albumin(ALB)of CAL was lower than those of NCAL in<4 years old group and 4-6 years old group(P<0.05);globin(CLO)of CAL was lower than that of NCAL,and albumin/globin(A/G)was a risk factor for CAL in≥6 years old group(P<0.05).Before IVIG treatment,WBC>18.02×10^(9)/L(OR=2.861,95%CI:1.750-4.678),MPV>9.15fl(OR=2.138,95%CI:1.294-3.531),ALB<36.65g/L(0R=2.336,95%CI:1.369-3.987)were independent risk factors to predict CAL of<4 years old group(P<0.05).Conclusion Analyzing the clinical characteristics of KD by age group is helpful to predict the occurrence of CAL more individually.