感染对川崎病的丙种球蛋白疗效和冠脉损伤的影响

目的探讨细菌感染对川崎病（Kawasaki disease，KD）的丙种球蛋白临床疗效的影响及与患者冠脉损伤的相关性。方法回顾性分析70例川崎病患儿血培养及超声心动图检查的结果，分析血培养阳性与丙种球蛋白治疗疗效及与冠脉损伤的相关性。结果血培养阳性率为21．43％，其中革兰染色阳性菌5例（7．14％），革兰阴性菌10例（14．26％）；血培养阴性的55例中，丙种球蛋白治疗总有效率76．36％（42／55），显著高于15例血培养阳性组（33．33％），差异具有统计学意义（X^2=-8．037，P〈0．01）。血培养阳性患儿超声心动图提示冠脉损伤9例，损伤率60％（9／15），血培养阴性患儿冠脉损伤率为30．91％（17／55），两组比较具有统计学意义（X^2=4．27，P〈0．05）。结论感染参与了川崎病的发病并影响患儿丙种球蛋白的疗效．增加患儿冠脉损伤的发生率。

The influence of infection on immunoglobulin efficacy and coronary artery leision in children with Kawasaki disease

Objective To explore the influence of infection on immunoglobulin efficacy in Kawasaki disease(KD) and the relationship between infection and Coronary Artery Leision(CAL).Methods The outcome of hemoculture and cardiac ultrasound in 70 KD patients were analyzed retrospectively,the relationship among positive rate,CAL and Immunoglobulin Efficacy were analyzed.Results The hemoculture positive rate was 21.43%,including 5 cases gram-positive bacteria and 10 cases gram-negative bacteria.The immunoglobulin efficacy was 76.36%(42/55) in 55 negative hemoculture,and significantly higher than 15 positive hemoculture(χ2=8.037,P <0.01).Nine of 15 positive hemoculture KD patients received cardiac ultrasound had CAL(60%).The incidence of CAL was higher in patients with hemoculture positive than in those with negative(χ2 =4.27,P < 0.05).Conclusion Bacterial infection may involve in the development of KD,impacting the treatment efficiency of Immunoglobulin and improving the Coronary Artery Leision rate.