摘要
目的分析小儿川崎病(KD)并发冠状动脉损伤(CAL)的特点及危险因素,为临床治疗及预后恢复提供相关依据。方法回顾性分析2020年1月至2021年5月宜春市人民医院儿科收治的180例KD患儿临床资料,根据有无并发CAL将其分为观察组(合并CAL)31例,对照组(无并发CAL)149例。两组患儿均常规进行静脉用丙种球蛋白(IVIG)治疗,统计两组患儿性别、年龄、IVIG开始使用时间等临床资料,将单因素分析有统计学差异的资料行多因素logistic分析,得出KD患儿并发CAL的危险因素。结果单因素分析显示,两组患儿的年龄、IVIG开始使用时间、IVIG抵抗、红细胞沉降率(ESR)、持续发热时间、治疗时间、C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、白介素-6(IL-6)、N末端B型利钠肽原(NT-proBNP)、血钠浓度、白细胞计数(WBC)、中性粒细胞与淋巴细胞比值(NLR)、血小板(PLT)比较,差异有统计学意义(P<0.05)。多因素logistic分析结果显示,持续发热时间(β=1.254,OR=3.504,95%CI=1.272~9.653)、NT-proBNP(β=0.708,OR=2.030,95%CI=1.170~3.521)、WBC(β=0.869,OR=2.385,95%CI=1.332~4.286)、PLT(β=0.657,OR=1.929,95%CI=1.361~2.734)、ESR(β=1.037,OR=2.821,95%CI=1.533~5.819)、NLR(β=0.946,OR=2.575,95%CI=1.262~5.256)均是影响KD患儿并发CAL的独立危险因素(P<0.05)。结论持续发热时间、NT-proBNP、WBC、NLR、PLT及ESR均是KD患儿并发CAL的危险因素,临床治疗时需注重以上指标,及时采取有效治疗措施。
Objective To analyze the characteristics and risk factors of coronary artery lesions(CAL)in children with Kawasaki disease(KD),so as to provide a basis for clinical treatment and prognosis.Methods The relevant clinical data of 180 children with KD admitted to the Pediatrics Department,Yichun People′s Hospital from January 2020 to May 2021 was retrospectively analyzed.According to the presence or absence of CAL,the children were divided into observation group(combined CAL,31 cases)and control group(non-CAL,149 cases).Both groups were treated with intravenous gamma globulin(IVIG).Gender,age,and the start time of using IVIG were collected.Multivariate logistic analysis was performed on the data with statistical differences in univariate analysis to screen the risk factors for CAL in children with KD.Results Univariate analysis showed that age,start time of using IVIG,IVIG resistance,erythrocyte sedimentation rate(ESR),duration of fever,treatment time,C-reactive protein(CRP),alanine aminotransferase(ALT),interleukin-6(IL-6),N-terminal pro-B-type natriuretic peptide(NT-proBNP)and serum sodium,decreased white blood cells(WBC),neutrophil-to-lymphocyte ratio(NLR)and platelet(PLT)were compared between two groups,the differences were statistically significant(P<0.05).Multivariate logistic analysis showed that duration of fever(β=1.254,OR=3.504,95%CI=1.272-9.653),NT-proBNP(β=0.708,OR=2.030,95%CI=1.170-3.521),WBC(β=0.869,OR=2.385,95%CI=1.332-4.286),PLT(β=0.657,OR=1.929,95%CI=1.361-2.734),ESR(β=1.037,OR=2.821,95%CI=1.533-5.819),and NLR(β=0.946,OR=2.575,95%CI=1.262-5.256)were independent risk factors for CAL in children with KD(P<0.05).Conclusion Duration of fever,NT-proBNP,WBC,NLR,PLT and ESR are risk factors for CAL in children with KD.Attention should be paid to above-mentioned indicators in clinical treatment,and effective treatment should be performed timely.
作者
黄丽
温雪风
唐小燕
胡冰
邬俊勇
HUANG Li;WEN Xuefeng;TANG Xiaoyan;HU Bing;WU Junyong(Department of Paediatrics,Yichun People′s Hospital,Jiangxi Province,Yichun336000,China)
出处
《中国当代医药》
CAS
2022年第24期5-8,13,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202212646)。
关键词
小儿川崎病
冠状动脉损伤
特点
危险因素
Pediatric Kawasaki disease
Coronary artery lesion
Characteristic
Risk factor
