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目的:了解珠海市川崎病(KD)的流行病学特征,探讨实验室指标异常协助临床诊断的意义以及与冠状动脉损害和丙种球蛋白(IVIG)抵抗的关系。方法:通过对珠海市4家三甲医院2003-2012年的KD住院患儿进行回顾性调查研究,分析KD的流行特点,并选取7项临床常用的实验室指标ESR、CRP、PLT、ALB、ALT、Hb和WBC进行分析,将各指标同冠状动脉损害和IVIG抵抗行Pearson卡方检验。结果:共收集562例,确诊患儿逐年上升,1-3岁为KD高发年龄段,男女比例1.97:1,4、5月为发病高峰。本组患儿ESR、CRP、PLT、ALT、WBC增高和ALB、Hb降低的发生率分别为94.8%、93.1%、92.5%、41.9%、82.2%和46.1%、51.1%。在不同年龄组中Hb异常发生率存在明显差异,ALB和Hb降低与冠状动脉损害有相关性(P﹤0.05),CRP、ALB、ALT、WBC和Hb与IVIG抵抗有相关性(P﹤0.05)。结论 :KD急性期ESR、CRP、PLT增高的发生率均﹥90%,可协助KD急性期的临床诊断。年幼儿较年长儿Hb降低的发生率高,ALB和Hb降低的患儿须提防存在冠状动脉损害,而CRP、ALT、WBC升高和ALB和Hb降低的患儿应注意有可能IVIG抵抗。
OBJECTIVE: To understand the epidemiological characteristics of Kawasaki disease (KD) in Zhuhai and to explore the significance of clinical laboratory parameters in assisting clinical diagnosis and its relationship with coronary artery lesions and immunoglobulin gamma (IVIG) resistance. Methods: The prevalence of KD in four KAP hospitals in Zhuhai from 2003 to 2012 was analyzed retrospectively. The prevalences of KD were analyzed and seven laboratory commonly used laboratory markers ESR, CRP, PLT, ALB, ALT , Hb and WBC were analyzed, the indicators with coronary artery lesions and IVIG resistance line Pearson chi-square test. Results: A total of 562 cases were collected. The diagnosed children increased year by year. The age of 1-3 was the high KD age group. The male / female ratio was 1.97: 1, 4 and 5 months. The incidence of ESR, CRP, PLT, ALT, WBC and ALB and Hb in children were 94.8%, 93.1%, 92.5%, 41.9%, 82.2% and 46.1%, 51.1% respectively. There were significant differences in the incidence of Hb abnormalities in different age groups, the correlation between ALB and Hb and coronary artery lesions (P <0.05), CRP, ALB, ALT, WBC and Hb were correlated with IVIG resistance (P <0.05) . Conclusion: The incidence of ESR, CRP and PLT in the acute stage of KD are all higher than 90%, which may be helpful for the clinical diagnosis of acute KD. Children younger than their older children with high incidence of Hb, ALB and Hb decreased children with coronary artery lesions should be guarded, and CRP, ALT, WBC increased and ALB and Hb decreased children should pay attention to the possibility of IVIG resistance.