小儿川崎病并发冠状动脉病变高危因素探析.docVIP

小儿川崎病并发冠状动脉病变高危因素探析 　【摘要】; 目的: 探讨川崎病并发冠状动脉病变的相关因素。 方法: 对86例确诊为川崎病患儿的临床表现、超声心动图、急性期C―反应蛋白、胆固醇、血沉、血小板、血红蛋白、白细胞等资料进行计量资料t检验和计数资料chi;2 检验。结果: 86例川崎病并发冠状动脉病变26例（30%)。相关因素分析显示：发病年龄、发热天数、血小板、C―反应蛋白、胆固醇与冠状动脉病变发生率有密切关系。用静脉丙种球蛋白（IVIG）治疗的冠状动脉病变发生率236%，仅用阿司匹林治疗的冠状动脉病变发生率571%，7d内使用IVIG治疗的冠状动脉病变发生率64%（P＜001）。结论: 对川崎病进行综合分析，可对该病作出及时的预后判断，予早期干预，促进冠状动脉病变的恢复；早期足量使用IVIG可减少KD并发冠状动脉病变的发生。 ; 【关键词】; 川崎病; 冠状动脉病变; 危险因素 ; 【ABSTRACT】; Objective: To investigate the relative rish factors for Kawasaki disease with complication of coronary artery disease. Methods: Restrospectively studied 86 children who suffered from the Kawasaki diseas. After investigating the clinical behavior,ultrasonic cardiograms and blood test results of acute prase(Including the Cholesterol、ESR、CRP、Platelet、Hemoglobin、Leucocyte),we analyzed the case by ttest and chiSquare test analysis. The incidence rate of coronary artery injury was 333% in cases who received IVIG therapy, while 642% in cases who only received aspirin therapy; but incidence rate of coronary artery injury was 96% in cases who received IVIG therapy within 7 days(Plt;001). Results: Among 86 cases, the number of patients who got the complication of coronary artery disease was 26(30%). After analyzing the risk factors we find that fever duration、platelet、CRP、Cholesterol had Close relationship with the disease of coronary artery(Plt;001). Conclusion: With help of medical analysis on the disease and combining the positive physical and laboratory findings,we can timely prediagnose the disease and give appropriate treatment in advance to prevent coronary artery disease and help the recovery of pathological changes for coronary artery； fulldose IVIG therapy in early stage can reduce the incidence of coronary artery injure. ; 【KEY WORDS】; Kawasaki disease; Coronary artery;Risk factor ; 川崎病（kawasaki disease, KD）又名皮肤粘膜淋巴结综合征，是一种原因不明确的儿童常见的自身免疫性血管炎综合征[1]。主要病理改变为全身非特异性血管炎，累及中小血管特别是冠状动脉，可形成冠状动脉瘤，引起血栓性梗塞、狭窄，导致心肌梗塞、猝死[2]。现对我院19961~20058月住院的86例KD患儿进行回顾性分析，旨在了解川崎病并发冠状动脉