| 川崎病患儿的临床特征、实验室指标及冠状动脉内径Z值变化分析 |
| 投稿时间：2024-12-26 修订日期：2025-01-06 点此下载全文 |
| 引用本文：齐恩林,周悦,赵静,马星,严慧芳,杨漪.川崎病患儿的临床特征、实验室指标及冠状动脉内径Z值变化分析[J].医学研究杂志,2025,54(5):118-123 |
| DOI：
10.11969/j.issn.1673-548X.2025.05.022 |
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| 基金项目:河北省医学科学研究课题计划项目(20232187) |
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| 中文摘要:目的 分析川崎病患儿的临床特征、实验室指标及冠状动脉内径Z值变化。方法 选取医院2022年1月~2024年10月80例川崎病患儿,根据冠状动脉病变(coronary artery lesion,CAL)情况分为非CAL组(n=51)及CAL组(n=29)。比较两组临床特征、实验室指标,测量并对比两组冠状动脉内径Z值[右冠状动脉主干Z值(RCA-Z)、左冠状动脉主干Z值(LCA-Z)、左冠状动脉前降支近端Z值(LAD-Z)],采用受试者工作特征(receiver operating characteristic, ROC)曲线分析冠状动脉内径Z值对川崎病合并CAL的诊断价值。结果 80例川崎病患儿以男性、年龄1~3岁、夏季发病、发热持续时间＜10天、双侧结膜充血、完全川崎病、静脉丙种球蛋白(intravenous immunoglobulin,IVIG)不耐药为主；CAL组发热持续时间≥10天占比高于非CAL组(P＜0.05)；两组在性别、年龄、季节分布、症状、疾病类型、IVIG耐药情况等方面比较,差异均无统计学意义(P＞0.05)；CAL组外周血血小板计数(platelet,PLT)、白细胞计数(white blood cell,WBC)、C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)水平均高于非CAL组,血红蛋白(hemoglobin,HGB)、白蛋白(albumin,ALB)均低于非CAL组(P＜0.05)；CAL组RCA-Z、LCA-Z、LAD-Z均高于非CAL组(P＜0.05)；绘制冠状动脉内径Z值诊断川崎病患儿合并CAL的ROC曲线,结果显示,RCA-Z、LCA-Z及LAD-Z联合诊断川崎病患儿合并CAL的AUC为0.926,高于三者单独诊断的0.813、0.831、0.801(P＜0.05)。结论 川崎病患儿以男性、年龄1~3岁、夏季发病、发热持续时间＜10天、双侧结膜充血、完全川崎病、IVIG不耐药为主,合并CAL患儿外周血PLT、WBC、CRP及PCT升高,而HGB及ALB降低,冠状动脉内径Z值对合并CAL具有较高的诊断效能。 |
| 中文关键词:川崎病 冠状动脉病变 临床特征 实验室指标 冠状动脉内径Z值 |
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| Analysis of Clinical Characteristics, Changes of Laboratory Indexes and Z Value of Coronary Artery Diameter in Children with Kawasaki Disease |
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| Abstract:Objective To analyze clinical characteristics, changes of laboratory indexes and Z value of coronary artery diameter in children with Kawasaki disease (KD). Methods A total of 80 children with KD in the hospital were enrolled between January 2022 and October 2024. According to presence or absence of coronary artery lesion (CAL), they were divided into non-CAL group (n=51) and CAL group (n=29). The clinical characteristics, laboratory indexes and Z values of coronary artery diameter [Z value of right main coronary artery (RCA-Z), Z value of left main coronary artery (LCA-Z), Z value of left coronary artery anterior descending (LAD-Z)] were compared between the two groups. The diagnostic value of coronary artery diameter Z value in CAL was analyzed by receiver operating characteristic (ROC) curves. Results In the 80 children with KD, proportions of male gender, age of 1-3 years, onset in summer, fever duration <10days, bilateral conjunctival hyperemia, complete KD and intravenous immunoglobulin (IVIG) non-resistance were higher. The proportion of fever duration ≥10days in CAL group was higher than that in non-CAL group (P<0.05), but there was no significant difference in gender, age, seasons distribution, symptoms, disease types or IVIG resistance between the two groups (P>0.05). The levels of peripheral blood platelet count (PLT), white blood cell count (WBC), C-reactive protein (CRP) and procalcitonin (PCT) in CAL group were higher than those in non-CAL group, while hemoglobin (HGB) and albumin (ALB) were lower than those in non-CAL group (P<0.05). RCA-Z, LCA-Z and LAD-Z in CAL group were greater than those in non-CAL group (P<0.05). The results of ROC curves analysis showed that AUC of RCA-Z combined with LCA-Z and LAD-Z in the diagnosis of CAL was 0.926, greater than that of single index (0.813,0.831,0.801; P<0.05). Conclusion In KD children, proportions of male gender, age of 1-3 years, onset in summer, fever duration <10days, bilateral conjunctival hyperemia, complete KD and IVIG non-resistance are higher. The peripheral blood PLT, WBC, CRP and PCT are increased, while HGB and ALB are decreased in those with CAL. Z value of coronary artery diameter has higher diagnostic efficiency for CAL. |
| keywords:Kawasaki disease Coronary artery lesion Clinical characteristic Laboratory index Z value of coronary artery diameter |
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