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急性川崎病实验室参数值对早期诊断和恰当治疗的临床意义。

Clinical implications in laboratory parameter values in acute Kawasaki disease for early diagnosis and proper treatment.

作者信息

Seo Yu-Mi, Kang Hyun-Mi, Lee Sung-Churl, Yu Jae-Won, Kil Hong-Ryang, Rhim Jung-Woo, Han Ji-Whan, Lee Kyung-Yil

机构信息

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Pediatrics, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.

出版信息

Korean J Pediatr. 2018 May;61(5):160-166. doi: 10.3345/kjp.2018.61.5.160. Epub 2018 May 28.

Abstract

PURPOSE

This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients.

METHODS

Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204).

RESULTS

The mean fever duration was 6.6±2.3 days, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other.

CONCLUSION

The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.

摘要

目的

本研究旨在根据发热持续时间分析实验室检查值,并评估川崎病(KD)急性期这些检查值之间的关系,以协助早期诊断早发型KD和不完全KD患者。

方法

根据就诊时的发热持续时间对KD患者(n = 615)的临床和实验室数据进行评估,并在有和无冠状动脉病变(CAL)的患者之间进行比较。为评估实验室指标之间的关系,使用发热持续时间为5天或6天的患者(n = 204)。

结果

平均发热持续时间为6.6±2.3天,CAL患者的比例为19.3%(n = 114)。在6天组中,C反应蛋白(CRP)和中性粒细胞差值最高,而血红蛋白、白蛋白和淋巴细胞差值最低。与无CAL的患者相比,有CAL的患者总发热持续时间更长,CRP和中性粒细胞差值更高,血红蛋白和白蛋白值更低。KD炎症高峰期的CRP、白蛋白、中性粒细胞差值和血红蛋白值之间呈正相关或负相关。

结论

KD全身炎症的严重程度反映在包括CRP、中性粒细胞差值、白蛋白和血红蛋白在内的实验室检查值中。在急性KD炎症高峰期之前通过重复检查观察这些实验室参数的变化可能有助于诊断早发型KD患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b170/5976566/b373013d3829/kjped-61-160-g001.jpg

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