川崎病129例临床特征及并发冠状动脉损伤影响因素分析

Analysis of clinical characteristics and factors affecting complicated coronary damage in 129 cases of Kawasaki disease

目的 探讨急性期川崎病的临床特征和实验室指标与冠状动脉损伤的关系。方法 对2020年7月-2022年9月于兰州大学第二医院就诊的129例急性期川崎病患儿临床资料进行回顾性总结及分析,依据有无冠状动脉损伤分为川崎病合并冠状动脉损伤组(CAL组)和川崎病未合并冠状动脉损伤组(NCAL组),依据临床表现分为典型川崎病组(CKD组)和不完全性川崎病组(IKD组)。分别比较两组患儿的急性期临床表现和实验室检测指标差异。结果 129例急性期川崎病患儿中男88例,女41例,男女之比为2.15∶1。CKD组63例,占48.84%,IKD组66例,占51.16%;CAL组73例,占61.24%,NCAL组56例,占38.76%。典型川崎病合并冠状动脉损伤27例,占42.86%,不完全性川崎病合并冠状动脉损伤46例,占57.14%,不完全性川崎病合并冠状动脉损伤发生率比典型川崎病合并冠状动脉损伤发生率高(P<0.05)。川崎病类型、白细胞计数、中性粒细胞计数、中性粒细胞比率、淋巴细胞计数、淋巴细胞比率、血小板体积分布宽度、血小板压积、球蛋白、白蛋白、丙氨酸转氨酶、天冬氨酸转氨酶/丙氨酸转氨酶、白细胞介素-6在CAL组和NCAL组间差异有统计学意义(P<0.05),不完全性川崎病、白细胞计数、淋巴细胞比率、血小板体积分布宽度、白细胞介素-6是川崎病合并冠状动脉损伤的危险因素(P<0.05)。结论 不完全性川崎病及急性期血清白细胞计数、淋巴细胞比率、血小板体积分布宽度、白细胞介素-6与川崎病患儿合并冠状动脉损伤密切相关,临床可考虑通过监测患儿急性期白细胞计数、淋巴细胞比率、血小板体积分布宽度、白细胞介素-6来预测冠状动脉损伤情况。

Objective To investigate the relationship between clinical features and laboratory examination of acute Kawasaki disease and coronary artery injury.Methods The clinical data of 129 children with acute Kawasaki disease admitted to the Second Hospital of Lanzhou University from July 2020 to September 2022 were summarized and analyzed into Kawasaki disease with coronary injury group(CAL group)and that with-out coronary injury group(NCAL group),and then divided into typical Kawasaki disease group(CKD group)and incomplete Kawasaki disease group(IKD group).Differences in clinical performance and laboratory test indicators in the acute phase were compared between the two groups.Results Of the 129 children with acute Kawasaki disease,88 were male and 41 female,compared at 2.15∶1.There were 63 cases in CKD group,representing 48.84%,and 66 cases in IKD group,representing 51.16%.There were 73 cases in CAL group,representing 61.24%,and 56 cases in NCAL group,representing 38.76%.27 cases of typical Kawasaki disease with coronary artery injury,accounting for 42.86%;46 cases of incomplete Kawasaki disease with coronary artery injury 46,accounting for 57.14%;the incidence of incomplete Kawasaki disease with coronary artery injury was higher than that of typical Kawasaki disease with coronary artery injury(P<0.05).Type of Kawasaki disease,white blood cell,neutrophil,neutrophil ratio,lymphocyte,lymphocyte ratio,platelet distribution width,platelet volume,globularproteins,albumin,aspartate transaminase,alanine transaminase,aspartate transam-inase/alanine transaminase and interleukin-6 were statistically different between CAL and NCAL groups(P<0.05),and incomplete Kawasaki disease,white blood cell,lymphocyte ratio,platelet distribution width and interleukin-6 were risk factors for Kawasaki disease with CAL(P<0.05).Conclusion Incomplete Kawasa-ki disease and acute serum white blood cell,lymphocyte ratio,platelet distribution width,and interleukin-6 are closely related to coronary artery injury in children with Kawasaki disease.Clinically,monitoring the acute phase serum white blood cell count,lymphocyte ratio,platelet distribution width,and interleukin-6 can be considered to predict coronary artery injury in children.