川崎病合并冠状动脉损伤的危险因素分析

目的:探讨川崎病(Kawasaki disease,KD)合并冠状动脉损伤(coronary artery lesions,CAL)的危险因素。方法:参照KD诊断标准,回顾性分析60例KD患儿发病早期(<10 d)临床治疗(单一糖皮质激素应用)和白细胞(WBC)计数、红细胞压积(HCT)、C反应蛋白(CRP)、心电图及超声心动图等各项指标;采用χ2检验和多元回归分析,分别检验上述因素与KD合并CAL的相关性。结果:发病10 d内单因素分析筛选出年龄、WBC、CRP、心电图及糖皮质激素应用与KD合并CAL密切相关(P<0.05);Logistic多元回归分析进一步提示早期糖皮质激素应用、WBC和心电图异常与KD合并CAL显著独立相关(P<0.05)。结论:发病10 d内可疑KD病例如有WBC显著升高、心电图异常及早期单一糖皮质激素的应用可作为KD合并CAL早期预测因子。

On risk factors for coronary artery lesions in Kawasaki disease

Objective:To investigate the risk factors on children with coronary artery lesions(CAL)in Kawasaki disease(KD).Methods: By the diagnostic criteria of KD,the clinical data from 60 children with KD within 10 days(<10 d) were studied in terms of the therapy(mono-glucocorticoids),white blood cell count(WBC),hematocrit(HCT),creactive protein(CRP),electrocardiogram(ECG)and echocardiogram.Chi-square test and multiple regression analysis were used to determine the correlation between the risk factors mentioned above and KD complicated with coronary arterial lesions.Results:Single factor analysis showed that KD complicated with coronary arterial lesions within 10 days was closely associated with the factors including age,WBC,CRP,electrocardiogram and glucocorticoid(P<0.05).Multivariate logistic regression analysis further confirmed that KD complicated with coronary arterial lesions with 10 days was independently correlated with the medication of glucocorticoid,WBC and electrocardiogram(P <0.05).Conclusion:The markedly elevated WBC,abnormality of electrocardiogram and early medication of simple glucocorticoid can be employed to estimate the early risk factors in the suspected children with KD complicated with CAL within 10 days of diagnosis.