川崎病患儿冠状动脉异常的临床特点及危险因素分析

Ce Wang
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摘要

目的分析婴儿川崎病的临床特点,探讨川崎病冠状动脉异常的危险因素。方法回顾性分析2018年1月1日至2018年12月31日300例川崎病患儿的临床资料,包括实验室检查和冠状动脉超声检查结果。比较婴幼儿与老年儿童川崎病的临床特点。分析川崎病患儿冠状动脉损伤的危险因素。结果川崎病患儿以不典型川崎病为主,结膜充血、肛周病变、斑块等典型变化明显高于老年患儿(P<0.01)。白细胞计数、血小板计数婴幼儿组高于高龄组,肝功能异常数显著高于高龄组(P<0.05)。11%的川崎病患儿发生冠状动脉扩张,多数患儿在3个月内恢复正常。采用Logistic模型设计分析川崎病患儿冠状动脉损伤的危险因素。发现男孩和CRP明显升高是川崎病患儿冠状动脉损伤的危险因素。结论婴儿川崎病有其自身特点。冠状动脉损伤的发生率高。及时诊断、鉴别诊断和对症治疗可降低冠状动脉损伤的发生率。同时保持随访,通过超声心动图监测冠状动脉的变化。关键词:婴幼儿;川崎病;冠状动脉异常;风险因素
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Clinical characteristics and risk factors of coronary artery abnormities in infants with Kawasaki disease
Objective To analyze the clinical characteristics of Kawasaki disease in infants and explore the risk factors of coronary artery abnormities in Kawasaki disease. Methods The clinical data of 300 children with Kawasaki disease from January 1, 2018 to December 31, 2018 were retrospectively analyzed, including laboratory tests and coronary ultrasound results.The clinical characteristics of infants with Kawasaki disease and elderly children with Kawasaki disease were compared.The risk factors of coronary artery injury in infants with Kawasaki disease were analyzed. Results The majority of infants with Kawasaki disease were atypical Kawasaki disease, and the typical changes of conjunctival congestion, perianal changes and plaque were significantly higher than those of elderly children (P<0.01). Leukocyte count and platelet count were higher in the infant group, and the number of children with abnormal liver function was significantly higher than that in the older group (P<0.05). Coronary artery dilatation occurred in 11% of infants with Kawasaki disease, and most of them returned to normal within 3 months.Logistic model design was used to analyze the risk factors of coronary artery injury in infants with Kawasaki disease.It was found that boys and CRP increased significantly were the risk factors of coronary artery injury in infants with Kawasaki disease. Conclusion Infant Kawasaki disease has its own characteristics.The incidence of coronary artery injury is high.Timely diagnosis, differential diagnosis and symptomatic treatment may reduce the incidence of coronary artery injury.At the same time, follow-up should be maintained to monitor the changes of coronary artery by echocardiography. Key words: Infants; Kawasaki disease; Coronary artery abnormities; Risk factors
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期刊介绍: Chinese Journal of Neurology was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry. Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals, Chinese Journal of Neurology, and Chinese Journal of Psychiatry. Chinese Journal of Neurology is now indexed by EM, SCOPUS, AJ, WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 2.755 in 2017, ranking the first among all neurological and psychological journals in China and among all the 142 medical journals published by the Chinese Medical Association. The journal is available both in print and online.
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