川崎病病儿红细胞沉降率和CRP变化及临床意义

目的 探讨红细胞沉降率（ESR）和C反应蛋白（CRP）在川崎病（KD）病儿中的变化及意义。方法 对2000年1月～2006年12月我院儿科收治的60例KD病儿治疗前及治疗4周后ESR及CRP检测结果 进行分析,并分析ESR和CRP的变化与心血管损害的关系。结果 60例KD病儿治疗前43例（71.7%）ESR大于40 mm/1 h,33例（55.0%）CRP大于30 mg/L;治疗后5例（8.3%）ESR大于40 mm/1 h,且CK-MB升高和冠状动脉扩张病儿的ESR明显高于CK-MB正常和冠状动脉未扩张病儿（z=3.225～6.452,P〈0.01）。以ESR〉40 mm/1 h和CRP〉30 mg/L为ESR和CRP升高的标准,低ESR＋低CRP组病儿100%有冠状动脉扩张;高ESR＋高CRP组病儿41.7%有冠状动脉扩张,8.3%有CK-MB升高。结论 ESR和CRP水平变化与KD的心血管损害关系密切。

CHANGES AND CLINICAL SIGNIFICANCE OF ERYTHROCYTE SEDIMENTATION RATE AND C-REACTION PROTEIN IN CHILDREN WITH KAWASAKI DISEASE

Objective To assess the changes and significance of erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） in children with Kawasaki disease （KD）. Methods Sixty children with KD treated from January, 2000 to December, 2006 were detected for ESR and CRP before and four weeks after treatment, the changes of ESR and CRP and their relationship with cardiovascular damage were analyzed. Results Before treatment, 43 children （71.7 %） had ESR value higher than 40 mm/ 1 h, 33（55%） had CRP higher than 30 mg/L. After treatment, there were five children （8.3%） whose ESR still higher than 40 mm/1 h; the ESR of the children with high CK-MB and dilated coronary artery was significantly higher than children with nor mal CK-MB and normal coronary artery （z=3. 225-6. 452,P〈0.01）. Taking ESR 40 mm/1 h and CRP 30 mg/L as dividing line, all those with ESR and CRP values lower than the dividing line had dilated coronary artery （100%）, only 41.7% of the children with ESR and CRP values lower than 8.3% had high CK-MB. Conclusion The changes of ESR and CRP were closely associated with cardiovascular injury in KD children.