血小板参数对川崎病诊断和预后判断的意义

目的观察川崎病（KD）患儿血小板参数变化并分析其对KD诊断和判断预后的意义。方法对确诊为KD病的23例患儿分别测定其急性期即入院发热时及恢复早期即热退1周内血小板数（PLT）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板压积（PCT）,同时测定33例同期年龄相仿发热患儿（非KD及血液系统疾病）以上血小板参数作为对照。KD患儿均行心脏彩色多普勒超声检查。对有和无冠状动脉异常患儿血小板参数分别进行比较。并对血小板各参数进行相关性分析。结果KD患儿PLT、PCT升高,恢复早期较急性期更显著（P〈0.001）。冠状动脉异常患儿与无异常患儿血小板参数比较无显著差异性（P〉0.05）。PLT与MPV、PDW呈负相关（r=0.358,0.268Pa〈0.05）;MPV与PDW,PLT与PCT呈正相关（r=0.428,0.945Pa〈0.001）;MPV与PCT无相关性（r=0.071P〉0.05）。结论血小板参数变化对KD诊断有非常重要意义,但是否能以血小板参数变化程度来判断病情恢复程度及预后还有待进一步研究。

Significance of Platelet Parameters in Children with Kawasaki Disease in Diagnosis and Prognosis

Objective To explore the diagnostic and prognostic significances of platelet parameters changes in Kawasaki disease(KD).Methods The platelet total(PLT),mean platelet volume(MPV),platelet distribution width(PDW)and plateletcrit(PCT)were measured in 23 cases of KD on acute febrile phase and early recovery phase.It was compared with 33 cases suffered from other febrile diseases during the same period and in similar ages.Each KD child should accept the cardiology ultrasonic examination.Results The level of PLT,PCT increased in KD patients.It was more significant in early recover period than in acute febrile period(P<0.001).There were no significant difference in platelet parameter between children with coronary artery involvement and that with no coronary artery involvement(P>0.05).PLT negatively correlated with MPV,PDW(r=0.358,0.268 Pa<0.05);PDW positively correlated with MPV and PCT positively correlated with PLT(r=0.428,0.945 Pa<0.001);MPV not correlated with PCT(r=0.071 P>0.05).Conclusions The changes of platelet parameter play a very important role in diagnosis of KD.But it still can not be certain that whether the changes can help us estimate the variety of the patients condition and prognosis of KD children.It requires further study.