Efficacy of Topical versus Oral 5-Aminosalicylate for Treatment of 2,4,6-Trinitrobenzene Sulfonic Acid-induced Ulcerative Colitis in Rats简

5-aminosalicylic acid（5-ASA） is drug of choice for the treatment of ulcerative colitis（UC）. In this study, the efficacy of topical versus oral 5-ASA for the treatment of UC was examined as well as the action mechanism of this medication. A flexible tube was inserted into the rat cecum to establish a topical administration model of 2,4,6-trinitrobenzene sulfonic acid（TNBS）-induced UC. A total of 60 rats were divided into sham operation group（receiving an enema of 0.9% saline solution instead of the TNBS solution via the tube）, model group, topical 5-ASA group, oral Etiasa group（a release agent of mesalazine used as positive control） and oral 5-ASA group（n=12 each）. Different treatments were administered 1 day after UC induction. The normal saline（2 mL） was instilled twice a day through the tube in the sham operation group and model group. 5-ASA was given via the tube in the topical 5-ASA group（7.5 g/L, twice per day, 100 mg/kg）, and rats in the oral Etiasa group and oral 5-ASA group intragastrically received Etiasa（7.5 g/L, twice per day, 100 mg/kg） and 5-ASA（7.5 g/L, twice per day, 100 mg/kg）, respectively. The body weight was recorded every day. After 7 days of treatment, blood samples were drawn from the heart to harvest the sera. Colonic tissues were separated and prepared for pathological and related molecular biological examinations. The concentrations of 5-ASA were detected at different time points in the colonic tissues, feces and sera in different groups by using the high pressure liquid chromatography（HPLC）. The results showed that the symptoms of acute UC, including bloody diarrhea and weight loss, were significantly improved in topical 5-ASA-treated rats. The colonic mucosal damage, both macroscopical and histological, was significantly relieved and the myeloperoxidase activity was markedly decreased in rats topically treated with 5-ASA compared with those treated with oral 5-ASA or Etiasa. The mRNA and protein expression of IL-1β, IL-6, and TNF-α was down-regulated in the colonic tissue of rats topically treated with 5-ASA, significantly lower than those from rats treated with oral 5-ASA or Etiasa. The concentrations of 5-ASA in the colonic tissue were significantly higher in the topical 5-ASA group than in the oral 5-ASA and oral Etiasa groups. It was concluded that the topical administration of 5-ASA can effectively increase the concentration of 5-ASA in the colonic tissue, decrease the expression of proinflammatory cytokines, alleviate the colonic pathological damage and improve the symptoms of TNBS-induced acute UC in rats.     

CLINICAL VALUE OF ALARM SYMPTOMS IN DIAGNOSIS OF LOWER GASTROINTESTINAL DISEASES

Objective To evaluate the clinical value of alarm symptoms in diagnosis of lower gastrointestinal diseases. Methods Data of consecutive autochthonous patients referred to the endoscopy center of Renji Hospital during the period of Oct. 2002 to Dec. 2003 were retrospectively analyzed. The prevalence of alarm symptoms in Shanghai patients with colorectal malignancies or other organic or functional lower gastrointestinal diseases was investigated. Results 83 （4. 9% ） cases of colorectal malignancies were found in 1681 patients referred to the center for colonoscopy because of lower gastrointestinal symptoms. All these malignancies were verified to be in the progressive stage. The prevalence of alarm symptoms was 81.9% （68/83）. Hematochezia （ OR 4. 1, 95% CI 3.3 -5.2, P 〈0. 001）, melena （0R6.4, 95%CI3. 7-11. 0, P 〈0. 001） and anemia （OR 9.6, 95?3. 7 - 25. 0, P 〈 0. 001 ） were the most common and specific alarm symptoms. All the patients without alarm symptoms were above the age of 40 years. 264 （15. 7% ） cases of organic colorectal diseases other than malignancies and 1334 （ 79. 4% ） cases with no causal pathology identified were found in 1681 patients, and the prevalence of alarm symptoms in these two groups was 48. 5% （128/264） and 14. 8% （197/1334）, respectively. Conclusion Alarm symptoms including hemotochezia, melena, and anemia were useful in distinguishing organic from functional colorectal diseases in patients over 40 years old at the onset of symptoms. Furthermore, hematochezia, melena, anemia, severe weight loss, and abdominal mass were helpful in differentiating malignant from non-malignant colorectal diseases. Colonoscopy should be recommended for patients regardless of age with these alarm symptoms, and so do patients above the age of 40 years with no alarm symptoms before the diagnosis of functional diseases are made.     

THE IMMEDIATE THERAPEUTIC EFFECT OF ACUPUNCTURE ON ACUTE MYOCARDIAL INFARCTION

The authors present 14 cases of acute my-ocardial infarction treated by acupuncture of Neiguan (P.6) point.The patients,12 male and2 female,ranged in age from 48 to 71 years.All 14 patients were admitted to hospitalwithin 24 hours after onset of illness.Acupunc-ture was performed immediately upon admissionin 10 cases,on the second day in 2 cases,andon the third and ninth days in the other 2 casesrespectively.The needles were applied atNeiguan on both arms until the patient felt a     

Treatment and Prognosis of Pituitary Adenomas in Children

In order to explore the treatments and prognosis of pituitary adenomas in children, the experience in the treatment of 15 children with pituitary adenomas was summed up. The clinical data of 15 children with pituitary adenomas in Tongji Hospital were retrospectively analyzed from Jan. 1997 to Aug. 2004, including 9 males and 6 females with the age ranging from 9-15 years old （mean 12.8）. The disease duration was 3 months to 5 years （mean 2 years）. Fourteen cases were subjected to the microsurgical operation through oral tanssphenoidal approach and one case to medical treatment. All cases were followed up from 1 to 5 years by imaging studies and endocrine investigation. The results showed that 13 eases obtained total removal of the tumor and one subtotal removal of tumor. No severe complications and operation death occurred. It was concluded that the tanssphenoidal approach was the optimal treatment for children with pituitary adenomas. Regular and long-term follow-up is of great importance.     

STAPHYLOCOCCAL SCALDED SKIN SYNDROME： RETROSPECTIVE ANALYSIS OF 82 CASES

Objective To explore distinctive clinical manifestations and appropriate treatment, and assess prognosis of staphylococcal scalded skin syndrome （SSSS）. Methods A retrospective analysis was conducted of the data of 82 cases of SSSS hospitalized at Xinhua Hospital during the period from May 1993 to September 2003. Results The disease in all the 82 patients occurred in their first decade （mean 2.5 years）. Possible predisposing factors were found in 48 （58. 5% ）. Fever was present in 78 （95. 1% ）. Radial spokes of crusting around mouth were present in 80 （ 97. 6% ）. Erythema began on the face, especially around the mouth and eye in 63 （ 76. 8% ）. The course was acute in all cases and the eruptions quickly spread to the whole body within one day to two days. Of the 82 cases of SSSS, 47 were complete form of SSSS, 27 were abortive form of SSSS, and 8 were between the two forms. Staphylococcus aureus with positive staphylocoagulase was isolated from the possible primary infection sites including pharynx, eyelid, conjunctiva, nose, ear, and skin in 18 of 31 patients. Microbiological cultures of bullae and little pustulae developed after the onset were negative in 16 cases. All the 82 patients completely recovered after receiving antibiotic therapy （ ceftriaxone, oxacillin） alone or in combination with human immunoglobulin （IVIG） therapy. Additional IVIG therapy was used in those patients who had systemic involvements such as pneumonia, fever higher than 38. 5℃ or leukocytosis. Conclusion SSSS is a spectrum disease. Besides abortive and complete forms, presenting between the two forms a new form might be appeared in 8 cases who developed both scarlatiniform rash and flaccid bullae. The abortive form and complete form are usually misdiagnosed clinically. Radial spokes of crusting around mouth seem to be characteristic manifestation of SSSS. All the patients in this study had favorable prognosis after receiving prompt diagnosis and appropriate treatment.     

Effects of ketamine and midazolam on morphology of dendritic spines in hippocampal CA1 region of neonatal mice

Background It is a common phenomenon that children experience multiple general anesthesias in clinical practice, which raises the question whether repeated exposure to general anesthetics would interfere with the development of the central nervous system of children. The present study was designed to evaluate the effects of repeated treatment with ketamine or midazolam on postnatal dendrite development by examining the morphology of the dendritic spines of the pyramidal neurons in the hippocampal CA1 region in mice.
Methods The transgenic green fluorescent protein-M line （GFP-M） mice were used in this study. Ketamine （100 mg/kg） midazolam （50 mg/kg） or saline （10 ml/kg） was administered intraperitoneally once a day on consecutive days from postnatal day 8 （P8） to postnatal day 12 （P12）. At postnatal day 13 （P13） and postnatal day 30 （P30）, the density and length of the apical dendritic spines of the pyramidal neurons in the hippocampal CA1 region were examined under a confocal microscope.
Results At P13, for both the ketamine group and the midazolam group, the dendritic spines were found with a comparatively lower density and longer average length than in the control group. At P30, no significant difference in the density or average length of dendritic spines was found between the anesthetic group and control group.
Conclusions This study indicated that repeated exposure to ketamine or midazolam in neonatal mice impaired dendritic spine maturation immediately afterwards, but this influence seemed to disappear during further postnatal development.     

Ninety-day administration of dl-3-n-butylphthalide for acute ischemic stroke: a randomized, double-blind trial

Background DI-3-n-butylphthalide （NBP）, first isolated from the seeds of celery, showed efficacy in animal models of stroke. This study was a clinical trial to assess the efficacy and safety of NBP with a continuous dose regimen among patients with acute ischemic stroke. Methods A randomized, double-blind, double-dummy trial enrolled 573 patients within 48 hours of onset of ischemic stroke in China. Patients were randomly assigned to receive a 14-day infusion of NBP followed by an NBP capsule, a 14- day infusion of NBP followed by aspirin, or a 14-day infusion of ozagrel followed by aspirin. The efficacy measures were Barthel index score and the modified Rankin scale （mRS） at day 90. Differences among the three groups on mRS were compared using X2 test of proportions （with two-sided e=0.05） and Logistic regression analysis was conducted to take the baseline National Institutes of Health Stroke Scale （NIHSS） score into consideration. Results Among the 535 subjects included in the efficacy analysis, 90-day treatment with NBP was associated with a significantly favorable outcome than 14-day treatment with ozagrel as measured by mRS （P 〈0.001）. No significant difference was found among the three groups on Barthel index at day 90. The rate of adverse events was similar among the three groups. Conclusions The 90-day treatment with NBP could improve outcomes at the third month after stroke. The NBP treatment （both intravenous and oral） is safe （ChiCTR-TRC-09000483）.     

Forty Cases of Insomnia Treated by Multi-output Electric Pulsation and Auricular Plaster Therapy

The writer has treated 40 cases of insomnia by the method of multi-output electric pulsation in combination with auricular plaster therapy (with a seed of Vaccariae segetalis 王不留行 taped tightly to a particular ear point and pressed) and received satisfactory therapeutic effects. A report follows. General Data Forty cases were enrolled from outpatients in the Department of Acupuncture and Moxibustion, with cases of mental disorders or cerebral organic disorders excluded. Of them, 16 cases were males and 24 females; 20 cases aged from 18-35 years, 12 from 36-50 years, and 8 over 51 years. The duration of sickness was from 2 weeks to 30 years. 65% of cases had to take tranquilizers for sleep.     

Prediction of H7N9 epidemic in China

Background In March 2013,human cases of infection with a novel A （H7N9） influenza virus emerged in China.The epidemic spread quickly and as of 6 May 2013,there were 129 confirmed cases.The purpose of this study was to analyze the epidemiology of the confirmed cases,determine the impacts of bird migration and temperature changes on the H7N9 epidemic,predict the future trends of the epidemic,explore the response patterns of the government and propose preventive suggestions.Methods The geographic,temporal and population distribution of all cases reported up to 6 May 2013 were described from available records.Risk assessment standard was established by analysing the temperature and relative humidity records during the period of extensive outbreak in three epidemic regions in eastern China,including Shanghai,Zhejiang and Jiangsu provinces.Risk assessment maps were created by combining the bird migration routes in eastern China with the monthly average temperatures from May 1993 to December 2012 nationwide.Results Among the confirmed cases,there were more men than women,and 50.4％ were elderly adults （age ＞61 years）.The major demographic groups were retirees and farmers.The temperature on the days of disease onset was concentrated in the range of 9℃-19℃; we defined 9℃-19℃ as the high-risk temperature range,0℃-9℃ or 19℃-25℃ as medium risk and ＜0℃ or ＞25℃ as low risk.The relative humidity on the days of disease onset ranged widely from 25％ to 99％,but did not correlate with the incidence of infection.Based on the temperature analysis and the eastern bird migration routes,we predicted that after May,the high-risk region would move to the northeast and inland,while after September,it would move back to north China.Conclusions Temperature and bird migration strongly influence the spread of the H7N9 virus.In order to control the H7N9 epidemic effectively,Chinese authorities should strengthen the surveillance of migrating birds,increase poultry and environmental sampling,improve live poultry selling and husbandry patterns and move from a ＂passive response pattern＂to an ＂active response pattern＂ in focused preventive measures.     

婴儿川崎病冠状动脉损害危险因素分析

目的探讨婴儿川崎病并发冠状动脉损害（CAL）的危险因素。方法分析我院2002年2月-2008年12月期间住院的婴儿川崎病患儿74例,并对CAL组及无冠状动脉损害（NCAL）组的临床及实验室资料进行统计学分析。结果74例婴儿川崎病中并发CAL36例（48.6％）。有关因素分析显示：①发热天数：热程≥10d与〈10d相比CAL发生率显著增高（X^2=7.402,P〈0.05）,差异有统计学意义;②CAL组血红蛋白（Hb）较NCAL组明显降低,差异有统计学意义（t=3.95,P〈0.001）;⑧CAL组C-反应蛋白（CRP）较NCAL组明显增高,差异有统计学意义（t=10.21,P〈0.001）。结论婴儿川崎病CAL发生率高,CAL与热程、Hb、CRP有明显相关性。凡热程≥10d、Hb降低、CRP显著增高（≥100mg／L）的婴儿川崎病均应给予足够重视,高度警惕CAL发生。     

Kobayashi评分体系在中国川崎病患儿中的临床应用价值

目的探讨在川崎病(Kawasaki disease,KD)初始治疗前,Kobayashi评分体系预测中国KD患儿并发冠状动脉损伤(CAL)的能效。方法回顾性分析113例KD患儿临床资料,将其分为冠状动脉损伤组(CAL组)与非冠状动脉损伤组(NCAL组);应用Kobayashi评分体系对所有患儿评分,用χ2检验分析各评分参数及依危险程度分组后的CAL发生率有无统计学差异,并分析该评分体系的能效。结果 CAL组43例,NCAL组70例,根据该评分体系分为低危组80例、高危组33例,单因素分析结果显示谷草转氨酶(AST)≥100U/L、外周血中性粒细胞百分比≥80%、C反应蛋白(CRP)≥100mg/L、年龄≤1岁是KD患儿并发CAL的危险因素,Kobayashi评分高危组的CAL发生率明显高于低危组(均P<0.05);该评分体系的灵敏度为0.56、特异度为0.87、符合率Kappa值为0.50。结论 Kobayashi评分体系的7个参数中AST≥100U/L、外周血中性粒细胞%≥80%、CRP≥100mg/L、年龄≤1岁被证明是中国KD患儿并发CAL的危险因素;该评分体系虽然可以预测中国KD患儿是否并发CAL,但能效不高。     

川崎病并发冠状动脉损害的危险因素及预后分析

目的 探讨川崎病（Kawasaki disease,KD）并发冠状动脉损害（CAL）的危害因素及预后。方法 对402例KD患儿的临床资料进行回顾性分析，对比未并发CAL的382例A组KD患儿和并发CAL的21例B组DK患儿的相关检验、治疗及随访结果。结果 两组患儿在性别及年龄比例上差异无显著性（P＞0.05），B组患儿平均热程、血小板（PLT）、C反应蛋白（CRP）及血沉（ESR）值明显高于A组（P＜0.05）。急性期约30％的KD患儿伴有心肌酶谱、肌钙蛋白Ⅰ、心电图或超声心动图的异常。A组患儿在≤10d内静脉滴注丙种球蛋白（IVIG）的占85.08%，B组仅占28.57%。超声心动图随访19例并发CAL的患儿，5例冠状动脉扩张（CAD）于短期恢复正常；11例冠状动脉瘤（CAA）有9例恢复或好转；3例巨大冠状动脉瘤（GCAA）回缩困难。结论 热程过长及未予静脉注射两种球蛋（IVIG）治疗是KD并发CAL最重要的危险因素，同时表现有PLT、ESR及CRP的显著升高。部分KD患者伴一过性心肌炎、心包炎或心内膜炎。KD并发CAA及CAD可好转或痊愈并发GCAA的预后不良。     

川崎病患儿并发冠状动脉损伤的危险因素

目的基于川崎病(Kawasaki disease,KD)患儿静脉注射免疫球蛋白(intravenous immunoglobulin,IVIG)初始治疗前的生物学指标检测,分析KD患儿并发冠状动脉损伤(coronary artery lesions,CAL)的危险因素。方法回顾性分析43例KD并发CAL(CAL组)患儿和70例KD未并发CAL(NCAL组)患儿的临床资料,进行单因素分析(χ2检验);对单因素分析结果提示与CAL发生率有显著相关的因素,进行多元Logistic逐步回归分析。结果男性、年龄≤1岁、白细胞计数(WBC)>12×109/L、血清白蛋白(ALB)<35g/L、中性粒细胞百分比>80%、超敏C反应蛋白(CRP)≥100mg/L是KD患儿并发CAL的危险因素,其OR值分别为1.69、4.02、3.06、2.42、2.92、4.05。结论存在男性、年龄≤1岁、WBC>12×109/L、ALB<35g/L、中性粒细胞百分比>80%、CRP≥100mg/L这些高危因素的KD患儿并发CAL可能性大,需要更强化的治疗,更密切的随访。     

川崎病并发冠状动脉病变高危因素分析

目的:探讨川崎病(kawasaki disease,KD)并发冠状动脉病变(coronary artery lesion,CAL)的危险因素。方法:回顾性分析2003年1月~2008年9月142例住院KD患儿的临床资料,分析KD并发冠状动脉病变的高危因素。结果:142例KD中并发CAL34例(23.9%),相关因素分析显示发病年龄、发热持续时间、血小板计数、低蛋白血症、低血钾与CAL发生有密切关系。结论:3岁以下患儿、血小板计数升高、发热持续时间长、低蛋白血症、低血钾是CAL的高危因素。     

甘肃地区581例川崎病患儿流行病学特征分析

背景　川崎病（KD）是一种与冠状动脉病变（CAL）相关的系统性血管炎,可导致心肌病、心肌梗死甚至死亡。目前,KD发病率逐年攀升,已成为儿童获得性心脏病最常见的病因,显著影响成年后个体远期心血管疾病的发生。因此了解该病的流行病学特征以及影响因素对降低疾病发生率有重要意义。目的　从人口学特征、时间分布和地域差异三方面探讨KD在甘肃地区的流行病学特征,以期为西部地区KD的管理和预防提供科学依据。方法　选取2012-2019年兰州大学第二医院收治的581例KD患儿为研究对象,根据入选患儿1个月内CAL发生情况将其分为KD合并CAL组（CAL组）和无CAL组（NCAL组）,根据发病年龄划分为≤1岁、>1~3岁、>3~6岁和>6岁4个年龄段。采用统一的调查表收集一般资料（年龄、性别、民族、发病时间等）、冠状动脉彩超结果。结果　（1）人口学特征：581例KD患儿的中位发病年龄为1.9（1.2,3.2）岁,男∶女为1.9∶1,男性患儿在KD人群中的发病比例随年龄的增长呈下降趋势（χ2趋势=5.100,P<0.05）。（2）时间分布：不同年份间KD病例数总体呈上升趋势（χ2趋势=122.348,P<0.001）;各季节患儿分布情况比较,差异有统计学意义（χ2=12.418,P=0.006）;春季患儿占比与年龄段呈负相关（rs=-1,P<0.001）,而秋季患儿占比与年龄段呈正相关（rs=1,P<0.001）。（3）地域差异：结合甘肃地理位置、自然条件和区域经济社会发展现状,将甘肃省划分为河西、陇中、陇东、陇东南、民族五大区域;依据城镇居民日常生活开支、职工平均工资和社会经济发展水平等将甘肃省按发达程度由高到低划分为四类地区。陇中（χ2趋势=86.011,P<0.001）、陇东南（χ2趋势=23.848,P<0.001）和民族区域的KD病例数（χ2趋势=17.463,P<0.001）均逐年增加;一类（χ2趋势=54.551,P<0.001）、二类（χ2趋势=20.586,P<0.001）、三类（χ2趋势=14.844,P<0.001）和四类地区的KD病例数（χ2趋势=36.013,P<0.001）均逐年增加。（4）影响因素：不同年份间合并CAL（χ2趋势=95.041,P<0.001）和NCAL的KD病例数（χ2趋势=38.719,P<0.001）均呈上升趋势,尤以CAL组为著（χ 2趋势=9.502,P<0.05）;多因素Logistic回归分析结果显示,年龄〔OR=3.011,95%CI（1.313,6.907）〕、性别〔OR=1.634,95%CI（1.137,2.349）〕和四类地区〔OR=1.772,95%CI（1.172,2.679）〕是KD合并CAL的影响因素。结论　甘肃地区KD患病人数逐年增加,以CAL组KD患儿的增长为著,疾病负担严重,经济欠发达地区尤为明显,为降低KD及其并发症发生率,需要提高公众对疾病严重性的认识、在夏季对男性婴幼儿适当加大防治力度（尝试对KD高危人群提前干预,如免疫调节）、建立健全KD随访机制、加强基层医生培训、开展多中心研究并持续监测KD的流行病学特征以获取与最佳预防策略、早期诊断、治疗时机和治疗选择相关的重要信息。     

MMP-1、IL-6及VEGF与川崎病患儿冠状动脉损伤的关系

目的观察川崎病患儿血清基质金属蛋白酶1(MMP-1)、白细胞介素6(IL-6)及血管内皮生长因子(VEGF)的表达水平,探讨其在小儿川崎病冠状动脉损伤(CAL)中的作用。方法选择2011年1月至2013年12月宝鸡市人民医院儿科就诊的川崎病患儿(川崎病组)54例,其中无冠状动脉损伤(NCAL)组24例,合并冠状动脉损伤(CAL)组30例,另以年龄相仿的20例健康体检儿童为健康对照组。分别检测患儿及健康儿童血清MMP-1、IL-6及VEGF水平。结果川崎病患儿急性期血清MMP-1为(19.2±4.1)μg/L、IL-6为(47.7±9.6)ng/L及VEGF为(214.5±15.8)ng/L。缓解期,血清MMP-1(13.1±3.5)μg/L、IL-6(14.4±5.5)ng/L及VEGF为(123.2±16.7)ng/L水平明显高于健康对照组(P<0.05),且CAL组较NCAL组升高更为显著。川崎病组急性期血清MMP-1及IL-6与外周血白细胞计数呈正相关(r=0.69,P<0.05;r=0.78,P<0.01),而VEGF水平与血清白蛋白呈负相关(r=-0.63,P<0.01)。结论 MMP-1、IL-6及VEGF在川崎病患儿,特别在伴CAL时表达明显升高,可能参与川崎病血管损伤尤其是CAL的病理生理过程。     

川崎病及其合并冠脉损伤的早期诊断

OBJECTIVE: To explore the possibility of early diagnosis of Kawasaki disease (KD) complicated by coronary artery lesions (CAL). METHODS: Medical records of 84 children with KD (2 months to 8 years of age) were reviewed retrospectively. Diagnosis of KD was based on current diagnostic criteria of KD. Laboratory examinations were performed for white blood cells (WBC), hemoglobin (HB), platelet counts (Plt), and C-reactive protein (CRP), along with electrocardiography (ECG) and echocardiography within 7 days after the onset of the disease. The Pearson correlation and multivariate analysis (logistic) were used for statistical analysis. RESULTS: During the first 7 days, clinical manifestations of the patients included fever (100%), conjunctivitis (71.46%), skin rash (66.7%), extremity change (54%), oral mucosa change (80%), and cervical lymphadenopathy (25%). Laboratory examinations revealed elevated WBC, CRP, and ECG (P<0.05, 0.05,0.01, respectively) in patients with CAL. Multivariate logistic regression analysis indicated that ECG positivity (P<0.01) and WBC increases (P<0.01) were independently correlated with CALs in acute KD. CONCLUSIONS: CRP (+), ECG (+), WBC count increase during the acute phase of KD are important indicators to predict CAL caused by KD.     

血浆前清蛋白对川崎病患儿冠状动脉病变的预测意义

目的 探讨血浆前清蛋白(PA)水平对川崎病(KD)患儿合并冠状动脉病变(CAL)的预测意义。方法 回顾性分析2014年1月至2018年12月安徽医科大学第一附属医院儿科收治的128例KD患儿(KD组)的临床资料和50例同期健康体检儿童(对照组)的体检资料。KD组根据临床特点分为典型KD组98例和不典型KD组30例,根据是否合并CAL分为CAL组23例和nCAL组105例,记录各组患者PA、中性粒细胞绝对值(NEUT)、血小板计数(PLT)、清蛋白(Alb)、谷丙转氨酶(ALT)、C反应蛋白(CRP)、血沉(ESR)及心脏多普勒超声心动图结果,对各组间以上指标进行相关性分析,并绘制受试者工作特征(ROC)曲线,得出PA的最佳截断值,计算PA判断KD合并CAL的敏感度和特异度。结果 治疗前KD组PA水平为(68.91±40.65)mg/L,低于对照组的(180.20±31.81)mg/L,差异有统计学意义(P<0.05);典型KD组PA水平(67.19±41.29)mg/L低于不典型KD组的(74.53±38.60)mg/L,但差异无统计学意义(P>0.05);CAL组PA水平(53.30±24.73)mg/L低于nCAL组的(72.33±42.69)mg/L,差异有统计学意义(P>0.05);根据ROC曲线,PA的截断值选为82.5 mg/L时,敏感度为87.0%,特异度为69.5%。结论 血浆PA水平有望作为KD患儿合并CAL的预测指标之一。