儿童川崎病冠状动脉病变危险因素分析

---------------------------------------------------------------最新资料推荐------------------------------------------------------ 儿童川崎病冠状动脉病变危险因素分析儿童川崎病冠状动脉病变危险因素分析 2019-03-27 12:00:30 中国现代医生 2019 年 3 期周芳许君贾黎红周杰林张晓晓杨明 [摘要] 目的探讨川崎病（KD）合并冠状动脉病变的危险因素。

方法回顾性分析 2019 年 1月～2019 年 12 月本院 169 例KD 住院患兒的临床资料；将 169 例 KD 分为 A、B 两组，其中 A 组为KD 合并冠状动脉病变，B 组为 KD 不伴冠状动脉病变；采用独立样本 t 检验分析两组年龄、发热天数、白细胞数、超敏 C 反应蛋白、血沉、血小板数、血清白蛋白、血钠、D 二聚体与 KD 冠状动脉病变的关系；同时采用 ROC 曲线分析血清白蛋白、血钠、D 二聚体预测冠状动脉病变的效能。

结果 KD冠状动脉病变发生率为 36.69%。

A、B 组患儿血清白蛋白、血钠、D 二聚体的差异有统计学意义（P0.05）。

ROC 曲线分析显示血清白蛋白、血钠、D 二聚体曲线下面积分别为 0.383、0.353 和0.715。

血清白蛋白35 g/L、血钠135 mmol/L、D 二聚体0.92 mg/L 是 KD 合并冠状动脉病变的危险因素。

结论 KD 的主要危害是冠状动脉病变；血清白蛋白35 g/L、血钠135 mmol/L、D 二聚体0.92 mg/L 是 KD 合并冠状动脉病变的危险因素。

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[关键词] 川崎病；冠状动脉病变；危险因素；D 二聚体 [中图分类号] R725.4 [文献标识码] B [文章编号] 1673-9701（2019）03-0056-04 Analysis on the risk factors of coronary artery disease in children with Kawasaki disease ZHOU Fang1 XU Jun2 JIA Lihong1 ZHOU Jielin2 ZHANG Xiaoxiao2 YANG Ming2 1.Department of Nephrology，Hangzhou Children’s Hospital，Hangzhou 310014， China； 2.Department of Neurology， Hangzhou Children’s Hosp ital，Hangzhou 310014，China [Abstract] Objective To investigate the risk factors of Kawasaki disease （KD） complicated with coronary artery disease. Methods The clinical data of 169 children with KD who were hospitalized in our hospital from January 2019 to December 2019 were retrospectively analyzed； the 169 cases of KD were divided into two groups：

group A and group B. Group A was KD complicated with coronary artery disease， and group B was KD without coronary artery disease； the relationship between age， fever days，white blood cell count， high sensitivity C-reactive protein，erythrocyte sedimentation rate，platelet count，serum albumin，serum sodium， D dimer and KD complicated with coronary artery disease were analyzed by independent sample t test； at the same time， ROC curve was used to analyze the

---------------------------------------------------------------最新资料推荐------------------------------------------------------ efficacy of serum albumin，serum sodium and D dimer in predicting coronary artery disease. Results The incidence rate of KD coronary artery disease was 36.69%. The differences of the levels of serum albumin， serum sodium and D dimer in children in group A and B were statistically significant （P0.05）. ROC curve analysis showed that the area under the curve of serum albumin， serum sodium and D dimer was 0.383，0.333 and 0.715， respectively. Serum albumin 35 g/L， serum sodium 135 mmol/L， D dimer0.92 mg/L were the risk factors of KD complicated with coronary artery disease. Conclusion The main risk of KD is coronary artery disease； serum albumin35 g/L， serum sodium135 mmol/L， and D dimer0.92 mg/L are the risk factors of KD complicated with coronary artery disease. [Key words] Kawasaki disease （KD）； Coronary artery disease； Risk factors； D dimer 川崎病（Kawasaki disease，KD）又名皮肤黏膜淋巴结综合征，是好发于 5 岁以下儿童的原因不明的自身免疫性血管炎综合征[1]。

其主要病理改变为全身中小血管的非特异性炎症，主要累及冠状动脉，导致冠状动脉扩张和冠状动脉瘤形成，冠状动脉瘤尤其是巨大瘤患儿易形成瘤内血栓，远期多发生冠状动脉狭窄或闭塞，导致心肌缺血、心肌梗死，甚至猝死[2-3]，目前 KD 已取代风湿热成为儿童

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