摘要
目的探讨川崎病(KD)患儿并发冠状动脉损伤(CAL)的特点及其危险因素。方法选取2016年1月至2020年2月我院儿科收治的KD住院患儿296例为调查对象,按照超声心动图检查结果是否发生CAL将其分为CAL组(97例)和NCAL组(199例)。计算KD患儿并发CAL的发生率;KD患儿并发CAL的危险因素筛选采用单因素χ2检验和多因素逐步Logistic回归法,筛选因素包括性别、年龄、持续发热时间、临床诊断、诊治时间、IVIG开始使用时间、IVIG抵抗、WBC、hs-CRP、ESR、PLT、ALB、cTnI、D-二聚体、血钠、心电图检查、激素治疗。结果我院KD患儿并发CAL的发生率为32.77%(97/296);单因素分析结果显示,两组年龄、持续发热时间、诊治时间、IVIG开始使用时间、IVIG抵抗、WBC、hs-CRP、ESR、PLT、ALB、cTnI、D-二聚体、血钠、心电图检查因素比较,差异有统计学意义(P<0.05);多因素分析结果显示,持续发热时间(OR=2.195)、诊治时间(OR=3.297)、IVIG抵抗(OR=4.367)、hs-CRP(OR=2.989)、ESR(OR=3.550)、cTnI(OR=5.328)、D-二聚体(OR=3.892)是KD患儿并发CAL的危险因素。结论KD住院患儿具有较高的CAL发生率,且影响其发生的危险因素较多,应针对这些高危因素进行早筛查、早诊断、早治疗,降低CAL的发生率,改善KD患儿预后。
Objective To investigate the characteristics and risk factors of coronary artery injury(CAL)in children with Kawasaki disease(KD).Methods A total of 296 children with KD who were admitted to the department of pediatrics in our hospital from January 2016 to February 2020 were selected as the subjects.According to echocardiogram to check whether CAL occurred,they were divided into CAL group(97 cases)and NCAL group(199 cases).The incidence of CAL in children with KD was calculated.The risk factors for CAL in children with KD were screened by single factorχ2 test and multivariate stepwise logistic regression.The screening factors mainly included gender,age,duration of fever,clinical diagnosis,diagnosis and treatment time,IVIG start time,IVIG resistance,WBC,hs-CRP,ESR,PLT,ALB,cTnI,D-dimer,blood sodium,electrocardiogram,hormone therapy.Results The incidence of CAL complications in children with KD in our hospital was 32.77%(97/296).Single factor comparison results showed that the age,duration of fever,diagnosis and treatment time,IVIG start time,IVIG resistance,WBC,hs-CRP,ESR,PLT,ALB,cTnI,D-dimer,blood sodium,and electrocardiogram between two groups were statistically different(P<0.05).The results of multivariate analysis showed that the duration of fever(OR=2.195),diagnosis and treatment time(OR=3.297),IVIG resistance(OR=4.367),hs-CRP(OR=2.989),ESR(OR=3.550),cTnI(OR=5.328),D-dimer(OR=3.892).Conclusion Hospitalized children with KD have a high incidence of CAL,and many risk factors affect its occurrence.Early screening,early diagnosis,and early treatment of KD should be aimed at these high-risk factors to reduce the incidence of CAL and improve the prognosis of children with KD.
作者
刘佳
李小红
乔贵雪
张慎荣
邵启民
LIU Jia;LI Xiaohong;QIAO Guixue;ZHANG Shenrong;SHAO Qimin(Department of Pediatrics,Hangzhou Children′s Hospital,Hangzhou 310014,China)
出处
《中国现代医生》
2021年第5期74-77,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020KY758)。
关键词
儿童
川崎病
冠状动脉损伤
危险因素
Children
Kawasaki disease
Coronary artery injury
Risk factors
