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目的:探讨川崎病(KD)合并二尖瓣返流患儿的临床特征及其与冠状动脉损害的关系。方法:选取我院KD患儿152例,其中初期(病程第0-2周)合并二尖瓣返流,后期(第4-7周)复查消失者为组Ⅰ;初期及后期均合并二尖瓣返流者为组Ⅱ;初期及后期均无二尖瓣返流者为对照组。比较3组患儿的年龄、性别、实验室资料(包括WBC、PLT、CK-MB、ALB、CRP、ESR)、冠状动脉扩张、左室增大、返流程度。结果:KD患儿初期二尖瓣返流的发生率为22.4%(34/152),后期为9.2%(14/152)。1例发生心力衰竭,3例出现一过性心功能不全,均为组Ⅱ中合并中度返流患儿。组Ⅰ、Ⅱ分别与对照组的性别、左室增大、冠状动脉扩张、WBC、CK-MB、ALB、CRP、ESR比较,差异均有统计学意义(P<0.05);组Ⅰ与组Ⅱ之间的左室增大、冠状动脉扩张、返流程度、WBC、CK-MB、CRP比较有统计学意义(P<0.05)。结论:KD所合并二尖瓣返流多可自行缓解,但返流严重或持续存在者可出现心功能不全或心力衰竭;合并二尖瓣返流者其炎症水平较高,易发生冠状动脉损害。
Objective: To investigate the clinical characteristics of children with Kawasaki disease (KD) complicated with mitral regurgitation and its relationship with coronary artery lesion. Methods: A total of 152 children with KD were enrolled in this study. The initial stage (course 0-2 weeks) with mitral regurgitation, the late stage (4-7 weeks) The valve regurgitant group Ⅱ; no early and late mitral regurgitation as the control group. The age, gender, laboratory data (including WBC, PLT, CK-MB, ALB, CRP and ESR), coronary dilatation, left ventricular enlargement and regurgitation were compared between the three groups. Results: The incidence of early mitral regurgitation in children with KD was 22.4% (34/152) and late stage was 9.2% (14/152). 1 case of heart failure, 3 cases of transient cardiac dysfunction, were in group Ⅱ with moderate reflux in children. There were significant differences in gender, LV enlargement, coronary artery dilatation, WBC, CK-MB, ALB, CRP and ESR between the two groups (P <0.05) Left ventricular enlargement, coronary artery dilation, degree of regurgitation, WBC, CK-MB, CRP were statistically significant (P <0.05). Conclusions: KD combined mitral regurgitation can relieve itself, but serious or persistent reflux may occur in patients with heart failure or heart failure; mergence of mitral regurgitation were associated with higher levels of inflammation, coronary artery damage prone .