Analysis on high risk factors of giant coronary artery aneurysms complicated with Kawasaki disease in 34 cases

LIU Xiaoqing; ZHONG Jiarong

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Analysis on high risk factors of giant coronary artery aneurysms complicated with Kawasaki disease in 34 cases

更新时间：2023-12-18

- Analysis on high risk factors of giant coronary artery aneurysms complicated with Kawasaki disease in 34 cases
- Journal of Chongqing Medical University Vol. 37, Issue 11, Pages: 984-988(2012)
- 作者机构：
  
  重庆医科大学附属儿童医院心血管内科,重庆,400014
- 作者简介：
- 基金信息：
- DOI：
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- Published：2012，
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LIU Xiaoqing, ZHONG Jiarong. Analysis on high risk factors of giant coronary artery aneurysms complicated with Kawasaki disease in 34 cases. [J]. Journal of Chongqing Medical University 37(11):984-988(2012)
DOI：

LIU Xiaoqing, ZHONG Jiarong. Analysis on high risk factors of giant coronary artery aneurysms complicated with Kawasaki disease in 34 cases. [J]. Journal of Chongqing Medical University 37(11):984-988(2012) DOI：

摘要

目的：探讨川崎病（Kawasaki disease，KD）并发巨大冠状动脉瘤（Giant coronary artery aneurysm，GCAA）的高危因素，为进一步预防GCAA的形成及随访治疗提供依据。方法：收集 2003 年 9 月至 2011 年 9 月在我院确诊为 KD 的患儿共 3 191 例，其中并发 GCAA 的患儿 34 例全部纳入作为研究对象，KD 并发中小冠状动脉瘤（Coronary artery aneurysms，CAA）的全部患儿 76 例，并发冠状动脉扩张（Coronary artery dilation，CAD）的病例共 2 020 例，从中随机抽取 304 例为 KD 并发 CAD 组，未并发任何冠脉损害的病例 1 061 例，从中随机抽取 216 例为冠脉正常组（Non-coronary artery lesion，NCAL）。对 4 组患儿的流行病学资料、心脏受累情况进行描述统计，再对与 GCAA 发生有关的因素行单因素分析，最后对有统计学意义的指标行 Logistic 多元回归分析，描述各指标的 OR 值及 95%CI。结果：纳入 GCAA 组患儿 34 例中，男 27 例，女 7 例，平均年龄为（4.8 ± 3.8）岁；中小 CAA 组患儿 76 例，其中男 54 例，女 22 例，平均年龄为（2.8 ± 2.6）岁；CAD 组患儿 304 例，其中男 212 例，女 92 例，平均年龄为（2.4 ± 1.9）岁；NCAL 组 206 例，其中男 113 例，女 103 例，平均年龄为（3.0 ± 2.2）岁。据本组 Pearson ?字2 检验结果显示：年龄<1.0岁或≥5.0岁、发热时间>14 d、白细胞计数≥20.00×109个/L、血红蛋白<90 g/L、血小板计数≥800×109个/L、C-反应蛋白>100 mg/L、血沉>100 mm/h、在病程的第 10 天以后应用首剂静脉丙种球蛋白（Intravenous immunoglobulin，IVIG）、对第1剂 2 g/kg 的 IVIG 不敏感者、红细胞压积降低与CAA的发生有关（P值均<0.05），Logistic多元回归分析显示：血沉>100 mm/h[OR=2.946，95%CI（1.167，7.439），P值=0.022]，发热时间>14 d[OR=3.317，95%CI（1.302，8.450），P值=0.012]两者为并发 GCAA 的独立危险因素。结论：发热时间>14 d、血沉>100 mm/h是并发 GCAA 的独立危险因素。

Abstract

Objective：To investigate the high risk factors of giant coronary artery aneurysms（GCAA） complicated with Kawasaki dis－ease（KD） and to provide references for prevention and follow up of GCAA. Methods：Totally 3 191 patients with KD from September 2003 to September 2011 in our hospital were enrolled including 34 patients complicated with GCAA（GCAA group），76 patients complicated with small or medium coronary artery aneurysms（CAA，small or medium CAA group），2 020 patients complicated with coronary artery dilation（CAD，304 patients were selected randomly as CAD group） and 1 061 patients with non coronary artery lesion （NCAL，216 patients were selected randomly as NCAL group）. Statistical description of epidemiological data and cardiac involvement of patients in the four groups was made. Chi-square test was used to analyze the possible risk factors of GCAA. Multiple Logistic re－gression analysis was performed to estimate the OR and 95%CI for the risk factors. Results：In the GCAA，small or medium CAA，CAD，NCAL group，the numbers of male，female cases were 27 and 7，54 and 22，212 and 92，113 and 103，respectively；their average ages were （4.8 ± 3.8） years，（2.8±2.6） years，（2.4±1.9） years，（3.0±2.2） years，respectively. Chi-square test showed that the fac－tors of age <1 year or ≥5 years，febrile days >14 d，white blood cell counts≥20.00×109/L，platelet counts≥800×109/L，hemoglobin <90 g/L，lower hematokrit，C-reactive peptide>100 mg/L，erythrocyte sedimentation rate（ESR） >100 mm/h，accepting the first intra－venous immunoglobulin（IVIG） until the 11 d after finishing the disease course，insensitivity to initial treatment with IVIG were as－sociated with CAA. Multiple Logistic regression analysis showed that ESR >100 mm/h[OR=2.946，95%CI（1.167，7.439），P=0.022]，febrile days >14 d [OR=3.317，95%CI（1.302，8.450），P=0.012] were the independent risk factors of GCAA. Conclusions：Febrile days>14 d，ESR >100 mm/h are the independent risk factors of GCAA.

关键词

川崎病巨大冠状动脉瘤高危因素

Keywords

Kawasaki diseasegiant coronary artery aneurysmsrisk factors

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