川崎病急性期血脂与年龄、冠状动脉病变及严重程度的关系

doi:10.12372/jcp.2023.22e1030

临床儿科杂志 ›› 2023, Vol. 41 ›› Issue (6): 455-458.doi: 10.12372/jcp.2023.22e1030

川崎病急性期血脂与年龄、冠状动脉病变及严重程度的关系

何方园¹, 何学华¹(), 袁勇华¹, 朱柳蓉¹, 吴意², 夏晓辉³

1.湖南省人民医院（湖南师范大学附属第一医院）儿童心血管科（湖南长沙 410005）
2.湖南省人民医院（湖南师范大学附属第一医院）检验科（湖南长沙 410005）
3.湖南省人民医院（湖南师范大学附属第一医院）超声科（湖南长沙 410005）

收稿日期:2020-12-25 出版日期:2023-06-15 发布日期:2023-06-12
通讯作者: 何学华电子信箱：he_xh101@163.com
基金资助:
长沙市科技计划项目(kq1801091)

Relationship between blood lipids and age, coronary artery disease and its severity in the acute stage of Kawasaki disease

HE Fangyuan¹, HE Xuehua¹(), YUAN Yonghua¹, ZHU Liurong¹, WU Yi², XIA Xiaohui³

1. Department of Children's Cardiovascular Disease, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, Hunan, China
2. Department of Laboratory Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, Hunan, China
3. Department of Ultrasound, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, Hunan, China

Received:2020-12-25 Online:2023-06-15 Published:2023-06-12

摘要/Abstract

摘要：

目的探讨川崎病患儿急性期血脂变化与年龄、冠状动脉病变及严重程度的关系。方法选取2018年1月至2020年12月收治的241例急性期川崎病患儿作为研究对象（川崎病组），另选本院体检的30例健康儿童作为对照组，比较两组间血脂 [血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）] 水平差异，比较川崎病患儿不同年龄段、有无冠脉病变（CAL）以及不同严重程度CAL组间血脂水平差异。结果川崎病组241例中男135例、女106例；中位年龄2.17（1.04~4.00）岁，<1岁40例，1~3岁120例，>3岁81例；CAL组94例、NCAL组147例；CAL组Ⅱ级68例、Ⅲ级17例、Ⅳ级9例。对照组30例中男14例、女16例，中位年龄3.00（2.00~5.00）岁。川崎病患儿急性期TG与LDL-C较对照组明显升高，而TC及HDL-C则较对照组明显降低，差异有统计学意义（P<0.05）。不同年龄组间TG差异有统计学意义（P<0.05），随年龄增长呈下降趋势。CAL组TG比NCAL组明显增高，差异有统计学意义（P<0.05）。不同严重程度CAL组间TG差异有统计学意义（P<0.05）。结论川崎病急性期TC和HDL-C降低，TG和LDL-C升高；TG水平与年龄、CAL及其严重程度相关。

关键词: 川崎病, 血脂, 冠状动脉病变, 儿童

Abstract:

Objective To investigate the relationship between the changes of blood lipid and age, coronary artery disease and its severity in children with Kawasaki disease (KD). Methods A total of 241 children with acute KD admitted from January 2018 to December 2020 were selected as the study subjects (KD group), and 30 healthy children who underwent physical examination in our hospital were selected as the control group. The levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) were compared between the two groups. The differences in blood lipid levels among KD children of different ages, with or without coronary artery lesions (CAL) and with different severity of CAL were compared. Results There were 241 patients (135 boys and 106 girls) in KD group, and the median age was 2.17 (1.04-4.00) years. Forty children were <1 year old, 120 were 1-3 years old, and 81 were >3 years old. There were 94 children in the CAL group and 147 in the non-CAL group. In the CAL group, 68 children were grade Ⅱ, 17 were grade Ⅲ and 9 were grade Ⅳ. The control group included 30 patients (14 boys and 16 girls) and the median age was 3.00 (2.00-5.00) years. The TG and LDL-C levels of KD children in the acute stage were significantly higher than those in the control group, while the levels of TC and HDL-C were significantly lower than those in the control group, and there were statistically significant differences (P<0.05). There were statistically significant differences in TG among different age groups (P<0.05), and TG showed a decreasing trend with the increase of age. TG in the CAL group was significantly higher than that in the non-CAL group, and the difference was statistically significant (P<0.05). There were statistically significant differences in TG among CAL groups with different severity (P<0.05). Conclusions In the acute stage of KD, the levels of TC and HDL-C were decreased, while the levels of TG and LDL-C were increased. The TG level was correlated with the age, whether CAL was complicated or not, and the severity of CAL in KD children.

Key words: Kawasaki disease, blood lipids, coronary artery lesion, child

何方园, 何学华, 袁勇华, 朱柳蓉, 吴意, 夏晓辉. 川崎病急性期血脂与年龄、冠状动脉病变及严重程度的关系[J]. 临床儿科杂志, 2023, 41(6): 455-458.

HE Fangyuan, HE Xuehua, YUAN Yonghua, ZHU Liurong, WU Yi, XIA Xiaohui. Relationship between blood lipids and age, coronary artery disease and its severity in the acute stage of Kawasaki disease[J]. Journal of Clinical Pediatrics, 2023, 41(6): 455-458.

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参考文献 12

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组别	例数	TG[M(P₂₅~P₇₅)]	TC(x±s)	HDL-C[M(P₂₅~P₇₅)]	LDL-C(x±s)
对照组	30	0.89（0.76~1.17）	4.08±0.54	1.49（1.27~1.74）	2.09±0.61
川崎病组	241	1.42（1.05~1.87）	3.64±0.89	0.76（0.53~1.09）	2.34±0.76
统计量		Z=4.78	t=2.61	Z=4.40	t=2.03
P		<0.001	0.009	<0.001	0.043

年龄	例数	TG[M(P₂₅~P₇₅)]	TC(x±s)	HDL-C[M(P₂₅~P₇₅)]	LDL-C(x±s)
<1岁	40	1.76（1.22~2.24）	3.83±1.05	0.74（0.56~1.07）	2.38±0.87
1~3岁	120	1.41（1.09~1.92）	3.55±0.88	0.72（0.51~1.07）	2.34±0.77
>3岁	81	1.36（0.95~1.68）	3.69±0.80	0.84（0.49~1.22）	2.31±0.70
统计量		H=7.31	F=1.75	H=0.87	F=0.03
P		0.026	0.417	0.647	0.986

组别	例数	TG[M(P₂₅~P₇₅)]	TC(x±s)	HDL-C[M(P₂₅~P₇₅)]	LDL-C(x±s)
CAL组	94	1.52（1.07~2.06）	3.60±0.94	0.70（0.51~1.11）	2.29±0.79
NCAL组	147	1.38（1.02~1.72）	3.65±0.87	0.77（0.54~1.09）	2.36±0.75
统计量		Z=2.21	t=0.73	Z=0.88	t=0.55
P		0.027	0.468	0.380	0.580

严重程度	例数	TG[M(P₂₅~P₇₅)]	TC(x±s)	HDL-C[M(P₂₅~P₇₅)]	LDL-C(x±s)
Ⅰ级	147	1.38（1.02~1.72）	3.65±0.87	0.77（0.54~1.09）	2.36±0.75
Ⅱ级	68	1.74（1.09~2.20）	3.64±0.95	0.71（0.51~1.03）	2.31±0.80
Ⅲ级	17	1.20（1.11~1.55）	3.48±0.71	0.60（0.52~1.17）	2.17±0.53
Ⅳ级	9	1.59（1.00~2.25）	3.54±1.20	0.77（0.34~1.19）	2.39±1.09
统计量		H=9.45	F=2.14	H=1.19	F=0.35
P		0.024	0.545	0.754	0.951

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川崎病急性期血脂与年龄、冠状动脉病变及严重程度的关系

Relationship between blood lipids and age, coronary artery disease and its severity in the acute stage of Kawasaki disease

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