中国实用儿科杂志

中国实用儿科杂志 ›› 2011, Vol. 26 ›› Issue (10): 777-.

• 论著 • 上一篇    下一篇

川崎病并发冠状动脉瘤预后研究

  

  1. 重庆医科大学附属儿童医院心血管内科，重庆　 400014
  • 出版日期:2011-10-06 发布日期:2011-10-13

Review and follow-up study on coronary aneurysms secondary to Kawasaki disease.

  1. Department of Cardiology，Children’s Hospital of Chongqing Medical University，Chongqing 400014 China
  • Online:2011-10-06 Published:2011-10-13

摘要：

摘要：目的　分析川崎病（KD）并发冠状动脉瘤（CAA）的高危因素及预后。方法　回顾性分析重庆医科大学附属儿童医院1993年1月至2009年12月3902例住院KD患儿的临床资料，对与冠状动脉损害发生有关的因素进行计数资料χ2检验、计量资料t检验，将单因素分析筛选出的变量行多因素Logistic回归分析；对随访的46例CAA患儿病后1、3、6个月和1、2、3、4、5年及5年以上CAA的恢复情况及不同剂量静脉注射丙种免疫球蛋白（IVIG）的远期疗效进行χ2检验。结果　（1）单因素分析结果：性别、年龄、热程、IVIG使用时机、血红蛋白（Hb）、红细胞沉降率（ESR）、血清白蛋白与KD并发CAA有关（P < 0.05），将单因素分析筛选出的上述因素作为自变量进一步行多因素分析，结果显示，Hb、ESR、IVIG使用时机与KD并发CAA呈独立相关性（P < 0.05），而性别、年龄、热程、血清白蛋白与KD并发CAA非独立相关（P > 0.05）；（2）小型CAA、中型CAA、巨大CAA的回缩时间逐渐延长（P < 0.05），年龄及IVIG的剂量与CAA的回缩时间无统计学相关性（P > 0.05）。结论　Hb < 100 g/L、ESR > 50 mm/h、IVIG使用时病程 > 10 d是KD并发CAA的高危因素；CAA的回缩时间与CAA的大小有关，与年龄及IVIG的剂量无关。

关键词: 川崎病, 冠状动脉瘤, 高危因素, 预后

Abstract:

Abstract：Objective　To explore the high risk factors and prognosis of coronary aneurysms（CAA） caused by Kawasaki disease（KD）. Methods　 Clinical data of 3902 patients with KD admitted to Children’s Hospital of Chongqing Medical University from January 1993 to December 2009 were collected and retrospectively reviewed. Risk factors associated with coronary artery lesion were analyzed. Chi-square test and logistic regression were performed. The followed-up 46 CAA cases’ recovery situation in 1 month，3 months，6 months，1，2，3，4，5 years，longer than 5 years and the long-term clinical effect of different IVIG doses were analyzed. χ2 test were performed. Results　（1）Chi-square test showed that gender，age，duration of fever，administration time of IVIG，hemoglobin （Hb），erythrocyte sedimentation rate （ESR） and serum albumin were significantly related to CAA（P < 0.05）. Multiple logistic regression analysis identified Hb，ESR and the administration time of IVIG were independent risk factors of CAA（P < 0.05）. （2） The retraction time of small CAA，middle CAA and GCAA are gradually extended （P < 0.05）. Dosage of IVIG and age were not significantly related to retraction duration of different sizes of CAA （P > 0.05）. Conclusion 　Hb < 100 g/L，ESR > 50mm/h and the administration time of IVIG later than 10th days are the high risk factors of CAA caused by KD. The retraction duration of CAA is associated with size of CAA，but is not associated with dosage of IVIG and age.

Key words: Kawasaki disease, coronary aneurysms, high risk factors, prognosis