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川崎病并发严重心血管后遗症的高危因素分析

Analysis of high-risk factors of severe cardiovascular sequelae in Kawasaki disease

    摘要
  • 摘要:
    目的 分析儿童川崎病(KD)并发严重心血管后遗症(SCS)的高危因素。
    方法 选取KD患者505例，根据是否存在冠状动脉病变(CAL)分为非严重心血管后遗症(N-GS)组474例和SCS组31例。分析年龄、性别、外周血中白细胞计数(WBC)、发热时间、血红蛋白(Hb)、C反应蛋白(CRP)、红细胞沉降率(ESR)、降钙素原(PCT)、血浆D-二聚体定量(D-D)、抗链球溶血素O定量测定(ASO)、EB病毒(EBV)、静脉注射免疫球蛋白(IVIG)无反应和KD再发与KD并发SCS的相关性。分析KD并发SCS的高危风险因素。
    结果 单因素分析结果显示，ESR、PCT、发热时间>10 d、KD再发、IVIG无反应与KD并发SCS有关(P < 0.05)。Logistic回归分析结果显示，发热时间>10 d(OR=6.73, 95%CI: 1.75~22.94, P=0.02)、KD再发(OR=3.87, 95%CI: 1.43~8.55, P=0.04)、IVIG无反应(OR=4.28, 95%CI: 1.62~9.75, P=0.03)为KD并发SCS的独立高危因素。
    结论 发热时间>10 d、KD再发及IVIG无反应是KD并发SCS的高危因素。

     

    Abstract:
    Objective To analyze the high-risk factors of severe cardiovascular sequelae (SCS) in children with Kawasaki disease (KD).
    Methods A total of 505 KD patients were selected and divided into non-severe cardiovascular sequelae (N-GS) group (474 cases) and SCS group (31 cases) according to the presence of coronary artery disease (CAL). Age, gender, peripheral blood white blood cell count (WBC), fever duration, hemoglobin (Hb), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), plasma D-dimer assay (DD), antistreptomolysin O assay (ASO), Epstein-Barr virus (EBV), intravenous immunoglobulin (IVIG) nonresponse and recurrence of KD were correlated with KD complicated with SCS. The high-risk factors of KD concurrent SCS were analyzed.
    Results Single factor analysis showed that ESR, PCT, fever time >10 days, KD recurrence and IVIG nonresponse were related to KD complicated with SCS (P < 0.05). Logistic regression analysis showed that fever time >10 days (OR=6.73; 95%CI, 1.75 to 22.94; P=0.02), KD recurrence (OR=3.87; 95%CI, 1.43 to 8.55; P=0.04) and IVIG nonresponse (OR=4.28; 95%CI, 1.62 to 9.75; P=0.03) were independent high-risk factors for KD complicated with SCS.
    Conclusion Fever time >10 days, KD recurrence and IVIG nonresponse are high-risk factors for KD complicated with SCS.

     

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