摘要
目的分析肺炎支原体感染对川崎病的影响及其机制,以期指导临床诊疗。方法回顾性分析2013年8月至2018年8月我科住院的496例川崎病患儿临床资料,其中合并肺炎支原体感染组193例,未合并肺炎支原体感染组303例。应用倾向评分匹配法1∶1校正2组的年龄、性别、是否为不完全型川崎病、是否使用糖皮质激素、丙种球蛋白使用时间、丙种球蛋白使用方法和阿司匹林初始剂量,比较2组患儿的总发热天数、冠状动脉直径、冠状动脉扩张发生率、冠状动脉瘤发生率和丙种球蛋白无反应发生率。结果川崎病合并肺炎支原体感染组男性患儿多,更易发生颈部淋巴结肿大,年龄、中性粒细胞百分比、血沉和低密度脂蛋白高于川崎病未合并肺炎支原体感染组,血钾、血钙、高密度脂蛋白和白蛋白低于川崎病未合并肺炎支原体感染组,差异有统计学意义(均P<0.05)。应用倾向评分匹配法1∶1配对后发现,川崎病合并肺炎支原体感染组患儿总发热时间更长[8(6~10)d vs 7(6~9)d,Z=-2.089,P<0.05),冠状动脉直径值更大[(2.81±0.81)mm vs(2.63±0.45)mm,t=2.532,P<0.05],冠状动脉瘤发生率更高(5.5%vs 1.1%,χ^(2)=5.516,P<0.05)。结论肺炎支原体感染可能引起川崎病患儿脂质代谢及电解质的紊乱,其炎症反应更强,持续时间更长,对冠状动脉损伤更大。
Objective To explore the effect of Mycoplasma pneumoniae(M.pneumoniae)infection on Kawasaki disease and its mechanism,so as to guide clinical diagnosis and treatment.Methods A retrospective analysis was performed on the clinical data of 496 paediatric patients who were diagnosed with Kawasaki disease and hospitalized in our hospital from August 2013 to August 2018,including 193 cases in the Kawasaki disease complicated with M.pneumoniae group(complication group)and 303 cases in the Kawasaki disease not complicated with M.pneumoniae group(non-complication group).The propensity score matching was used to adjust the age,gender,proportion of incomplete Kawasaki disease,proportion of glucocorticoid use,time of IVIG administration,regimens of IVIG administration and initial aspirin doses in the two groups.The duration of fever,coronary artery diameter,incidence of coronary artery dilation,incidence of coronary artery aneurysm and incidence of IVIG resistance were compared between the two groups.Results Compared with non-complication group,the complication group had significantly higher proportions of male children,cervical lymphadenopathy and elder age,higher neutrophils,erythrocyte sedimentation rate and low density lipoprotein(all P<0.05),while significantly lower serum potassium,serum calcium,high density lipoprotein and albumin(all P<0.05).After propensity score matching,compared with non-complication group,the complication group had significantly longer duration of fever[8(6-10)d vs 7(6-9)d,Z=-2.089),larger coronary artery diameter[(2.81±0.81)mm vs(2.63±0.45)mm,t=2.532]and higher incidence of coronary artery aneurysm(5.5%vs 1.1%,χ^(2)=5.516)(all P<0.05).Conclusion MP infection in children with Kawasaki disease may cause disorders of lipid metabolism and electrolyte,has more severe and longer inflammation response and higher risk of coronary artery lesions.
作者
林翊君
林杉
王程毅
陈钦
刘光华
LIN Yijun;LIN Shan;WANG Chengyi;CHEN Qin;LIU Guanghua(Department of Pediatrics,Fujian Provincial Maternity and Children′s Hospital,Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian,350001,China;不详)
出处
《中国微生态学杂志》
CAS
CSCD
2020年第12期1413-1418,共6页
Chinese Journal of Microecology
基金
福建省妇幼保健院科技创新启动基金(YCXZ18-08)。
关键词
肺炎支原体
川崎病
冠状动脉损伤
临床特点
Mycoplasma pneumoniae
Kawasaki disease
Coronary artery lesions
Clinical characteristics
