摘要
目的探讨感染因素对川崎病(KD)及其冠状动脉病变的影响。方法回顾性收集广州市越秀区儿童医院2010年1月至2019年12月明确诊断为KD的172例住院患儿,并将其分为KD合并感染组与KD无感染组,其中KD合并感染的患儿共有43例,KD无感染共有129例;KD合并感染组涉及的常见非细菌性病原微生物包括:肺炎支原体(MP)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、柯萨奇B病毒(CBV);对两组感染情况、年龄、性别、临床表现、血常规、生化指标、免疫球蛋白:免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)进行比较,并行超声心动图检查,比较两组患儿冠状动脉病变情况。结果在172例KD住院患儿中,KD合并感染率为25%(43/172);两组患儿出现冠状动脉病变共61例,总发生率为35.47%(61/172),其中,KD合并感染组出现冠状动脉病变发生率为48.84%(21/43),KD无感染组出现冠状动脉病变发生率为31.01%(40/129),两组比较差异有统计学意义(P<0.05)。KD合并感染组IgA(1.22±0.98g/L)、IgM(1.41±0.47g/L)、IgG(8.96±3.71g/L),均较KD无感染组IgA(0.88±0.76g/L)、IgM(1.16±0.48g/L),IgG(7.59±2.5g/L)显著升高,差异有统计学意义(均P<0.05);KD合并感染组ESR(36.13±24.38mm/h)较KD无感染组ESR(27.46±19.44mm/h)高,两组比较差异有统计学意义(均P<0.05)。结论 KD合并感染后急性期更容易出现体液免疫功能的紊乱,炎症反应更强烈,KD合并感染后冠脉损伤的发生风险增加。
Objective To investigate the impact of infectious factors on Kawasaki disease(KD)and coronary artery disorders.Methods A retrospective review was conducted on data from 172 children with KD hospitalized and diagnosed in Guangzhou Yuexiu District Children’s Hospital between January 2010 and December 2019.The children were divided into the KD with infection group(n=43)and KD without infection group(n=129).The common non-bacterial pathogenic microorganisms involved in the KD with infection group include:Mycoplasma pneumoniae(MP),Chlamydia pneumoniae(CP),adenovirus(ADV),respiratory syncytial virus(RSV),and Coxsackie B virus(CBV).The two groups were compared for infections,age,gender,clinical manifestations,blood routine test,biochemistry,immunoglobulins(Ig)-A,G and M.Echocardiography was performed to compare the coronary artery disorders in the two groups of children.Results Of the 172 hospitalized children with KD,infections was found in 25%(43/172).Coronary artery disorders were found in 61 children from the two groups,with an incidence rate of 35.47%(61/172);among them,the incidence of coronary artery disorders was 48.84%(21/43)in the KD with infection group vs 31.01%(40/129)in the KD without infectin group,with statistically significant difference between groups(P<0.05).The levels of IgA(1.22±0.98g/L),IgM(1.41±0.47g/L),and IgG(8.96±3.71g/L)in KD with infection group were significantly higher than those[IgA(0.88±0.76g/L),IgM(1.16±0.48g/L)and IgG(7.59±2.5g/L)]in KD without infection group,with statistically significant differences between groups(all P<0.05).The ESR in the KD with infection group(36.13±24.38mm/h)was higher than that in the KD without infection group(27.46±19.44mm/h),with statistical difference between the two groups(all P<0.05).Conclusion In KD children,concomitant infection is prone to humoral immune dysfunction in the acute phase as well as more intense inflammatory response.KD with infection is associated with higher risk of coronary artery injury.
作者
赖来清
张宙
郭惠娴
廖嘉仪
Lai Laiqing;Zhang Zhou;Guo Huixian;Liao Jiayi(Department of Respiratory Medicine,Yuexiu District Children's Hospital,Guangzhou 510115,China)
出处
《中华生物医学工程杂志》
CAS
2021年第4期369-374,共6页
Chinese Journal of Biomedical Engineering
基金
广州市越秀区科技计划项目(2019-WS-001)。
关键词
川崎病
黏膜皮肤淋巴结综合征
感染
免疫球蛋白
冠状动脉病变
Kawasaki disease
Mucocutaneous lymph node syndrome
Infection
Immunoglobulin
Coronary artery disorder
