目的 探讨兰州地区川崎病(KD) 患儿并发冠状动脉损害(CAL) 的危险因素。方法 对确诊的174 例KD患儿,根据其是否并发CAL 分为CAL 组和NCAL 组,分析比较其年龄、性别、热程、静脉用丙种球蛋白(IVIG) 开始使用时间、IVIG 使用剂量、C 反应蛋白(CRP)、血清白蛋白、红细胞沉降率(ESR)、血小板(PLT)、血红蛋白等资料的差异。结果 174 例KD 患儿并发CAL 者46 例( 占26.44%),无并发CAL 者128 例;两组患儿平均热程、自发热到开始IVIG 治疗的时间、IVIG 使用剂量,以及PLT、CRP、ESR、红细胞计数(RBC) 的差异均有统计学意义(P<0.05)。结论 热程>10 d、发热10 d 后开始使用IVIG,PLT、CRP、ESR 升高,RBC 降低的KD 患儿应警惕并发CAL 的危险性,对于KD 的治疗及预后判断有一定的参考价值。
Objective To investigate the risk factors for coronary artery lesions (CALs) in children with Kawasaki disease (KD) in Lanzhou. Methods One hundred and seventy-four children with diagnosed KD were divided into CAL group and non-CAL group based on the existence of concurrent CALs. The age, gender, fever duration, intravenous immunoglobulin (IVIG) start time, IVIG dose, C-reactive protein (CRP), serum albumin, erythrocyte sedimentation rate (ESR), platelet (PLT), red blood cell count (RBC), hemoglobin and so on were compared. Results Among the 174 children, 46 children (26.44%) were complicated by CALs and 128 children were not. The differences of average fever duration, IVIG starting time, IVIG dose, PLT, CRP, ESR and RBC were statistically significant (P<0.05). Conclusions When KD children has the fever durations >10 d, start of IVIG after 10 days of fever, increase of PLT, CRP and ESR and decrease of RBC, clinicians should be alert to the risk of concurrent CAL.