肺炎支原体感染对川崎病患儿的影响

Effect of mycoplasma pneumoniae infection on children with Kawasaki disease

摘要:

目的 探讨肺炎支原体（MP）感染对川崎病（KD）患儿炎症状态及并发冠状动脉损害（CAL）的影响。 方法 将128 例KD 患儿分为MP 感染组42 例，非MP 感染组86 例，分析两组热程、不完全KD 比例及静脉丙 种球蛋白（IVIG）无反应比例等临床特征。比较患儿急性期、缓解期白细胞计数（WBC）、中性粒细胞与淋巴 细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及超敏C 反应蛋白（hs-CRP）等炎症指标及并发CAL 情 况的差异。结果 KD 急性期MP 感染组NLR、PLR、hs-CRP 及红细胞沉降率（ESR）均高于非MP 感染 组（P <0.05），缓解期MP 感染组PLT 和hs-CRP 高于非MP 感染组（P <0.05）。MP 感染组IVIG 无反应、 CAL 发生率及左冠状动脉内径/ 主动脉环内径（LCA/AOA）比值均高于非MP 感染组（P <0.05）。结论 合 并MP 感染的KD 患儿机体免疫炎症反应更为强烈，发生IVIG 无反应以及CAL 的风险均增高。

Abstract:

Objective To investigate the effect of mycoplasma pneumoniae (MP) infection on inflammatory status and coronary artery lesions (CAL) in Kawasaki disease (KD) children. Methods Totally 128 children with KD were divided into MP group (n = 42) and non-MP group (n = 86). The clinical features of the groups including fever duration, proportion of incomplete KD and IVIG resistance were recorded. White blood cell count (WBC), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), high sensitive C reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), ratio of LCA/AOA and incidence of CAL were compared. Results NLR, PLR, hs-CRP, ESR and PLT in acute phase of MP patients were significantly increased compared with non-MP group (P < 0.05); hs-CRP and PLR in remission phase of MP group were significantly upregulated when compared with non-MP group (P < 0.05). Patients in MP group experienced increased incidence of IVIG resistance, CAL and ratio of LCA/AOA compared with non-MP infection group (P < 0.05). Conclusions KD children with MP infection have more severe inflammatory response and higher risk of IVIG resistance and CAL.