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目的探讨6月龄以下婴儿川崎病B型利钠肽(BNP)在急性期、恢复期的变化及临床表现。方法选择27例6月龄以下川崎病婴儿为实验组,45例1~3岁川崎病幼儿为对照Ⅰ组,45例6月龄以下支气管炎患儿为对照Ⅱ组,分别在三组患儿的急性期及实验组和对照Ⅰ组的恢复期检测血清BNP及C反应蛋白(CRP)、ESR、PLT等指标,并对BNP予以对比;同时对实验组和对照Ⅰ组在皮疹、手足肿胀、结膜充血、口唇皲裂、颈部淋巴结肿大以及冠状动脉扩张的发生率进行比较。结果实验组患儿的皮疹、手足肿胀、结膜充血、口唇皲裂、颈部淋巴结肿大发生率低于对照Ⅰ组(P<0.05,P<0.01);冠状动脉扩张及不典型川崎病发生率高于对照Ⅰ组(P均<0.05)。急性期实验组、对照Ⅰ组患儿BNP值高于对照Ⅱ组(P均<0.01),实验组与对照Ⅰ组BNP值亦有统计学差异(P<0.05);而在恢复期两组川崎病患儿BNP值组间比较及两组与对照Ⅱ组急性期比较,差异均无统计学意义(P均>0.05)。结论 6月龄以下婴儿不典型川崎病发生率高于1~3岁幼儿组;BNP是辅助诊断川崎病的一个重要指标。
Objective To investigate the changes and clinical features of B-type natriuretic peptide (B-type natriuretic peptide) in acute and convalescent Kawasaki disease in infants younger than 6 months old. Methods Twenty-seven infants with Kawasaki disease under 6 months of age were selected as experimental group, 45 infants with Kawasaki disease aged 1-3 years as control group Ⅰ and 45 infants with bronchitis under 6 months of age as control group Ⅱ, The acute phase and experimental group and control group Ⅰ recovery phase detection of serum BNP and C-reactive protein (CRP), ESR, PLT and other indicators, and BNP be compared; the experimental group and control group Ⅰ rash, hand-foot swelling, Conjunctival hyperemia, chapped lips, enlarged cervical lymph nodes and the incidence of coronary artery dilatation. Results The incidence of rash, hand-foot swelling, conjunctival hyperemia, lip chapped, and cervical lymph nodes in the experimental group was lower than that in the control group Ⅰ (P <0.05, P <0.01). The incidence of coronary artery dilatation and atypical Kawasaki disease were high In control group Ⅰ (all P <0.05). BNP levels in acute phase experimental group and control group Ⅰ were higher than those in control group Ⅱ (all P <0.01), and BNP values in experimental group and control group Ⅰ were also significantly different (P <0.05) There was no significant difference in BNP value between two groups and between two groups and control group Ⅱ (all P> 0.05). Conclusions The incidence of atypical Kawasaki disease in infants younger than 6 months is higher than that of children aged 1-3 years old. BNP is an important indicator in the diagnosis of Kawasaki disease.