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川崎病眼部表现、实验室检查、超声心动图表现与静脉注射免疫球蛋白抵抗的关系。

Relationship between ocular manifestations, laboratory findings, echocardiographic findings, and intravenous immunoglobulin resistance in Kawasaki disease.

机构信息

Department of Pediatric Rheumatology, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Pediatr Rheumatol Online J. 2024 May 1;22(1):50. doi: 10.1186/s12969-024-00985-1.

Abstract

BACKGROUND

This study investigates the incidence of ocular involvement in Kawasaki disease (KD) and evaluates the relationship between ocular manifestations, laboratory findings, echocardiographic findings, and intravenous immunoglobulin (IVIG) resistance.

METHODS

We conducted a cross-sectional study with 58 KD patients from June 2021 to March 2023. For all patients, a complete ophthalmologic examination and echocardiography were performed in the acute phase before starting the treatment. We analyzed the age, sex, mean of white blood cell (WBC) count, platelet count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), echocardiographic findings and IVIG responses for all patients and compared the group with ocular involvement with the group without involvement.

RESULTS

The incidence of bilateral acute conjunctivitis was 70.7%, while that of acute uveitis was 30%. Patients with uveitis had significantly higher rates of Coronary artery dilatation and IVIG resistance, as well as higher mean levels of WBC, platelet, and CRP compared to those without uveitis. (P < 0.05). Additionally, the age of patients with uveitis involvement was lower than those without involvement. No significant relationships existed between ESR, AST, or ALT values and uveitis (P > 0.05). Furthermore, no significant correlations existed between any examined items and acute bilateral conjunctivitis.

CONCLUSION

Uveitis in KD is significantly associated with coronary artery dilatation, IVIG resistance, higher WBC count, platelet count, and CRP level.

摘要

背景

本研究旨在调查川崎病(KD)眼部受累的发生率,并评估眼部表现、实验室检查、超声心动图检查结果与静脉注射免疫球蛋白(IVIG)抵抗之间的关系。

方法

我们进行了一项横断面研究,纳入了 2021 年 6 月至 2023 年 3 月期间的 58 例 KD 患者。所有患者在开始治疗前的急性期均进行了全面的眼科检查和超声心动图检查。我们分析了所有患者的年龄、性别、白细胞计数(WBC)、血小板计数、红细胞沉降率(ESR)、C 反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)水平、超声心动图检查结果和 IVIG 反应,并比较了有眼部受累和无眼部受累的患者。

结果

双眼急性结膜炎的发生率为 70.7%,急性葡萄膜炎的发生率为 30%。葡萄膜炎患者的冠状动脉扩张和 IVIG 抵抗发生率明显更高,WBC、血小板和 CRP 水平也明显高于无葡萄膜炎患者(P<0.05)。此外,葡萄膜炎患者的年龄明显低于无葡萄膜炎患者。ESR、AST 或 ALT 值与葡萄膜炎之间无明显相关性(P>0.05)。另外,任何检查项目与急性双侧结膜炎之间均无明显相关性。

结论

KD 中的葡萄膜炎与冠状动脉扩张、IVIG 抵抗、较高的 WBC 计数、血小板计数和 CRP 水平显著相关。

相似文献

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Evolution of laboratory values in patients with Kawasaki disease.川崎病患者实验室指标的演变。
Pediatr Infect Dis J. 2011 Dec;30(12):1022-6. doi: 10.1097/INF.0b013e31822d4f56.

本文引用的文献

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The epidemiology of Kawasaki disease: a global update.川崎病的流行病学:全球最新情况
Arch Dis Child. 2015 Nov;100(11):1084-8. doi: 10.1136/archdischild-2014-307536. Epub 2015 Jun 25.
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Acute anterior uveitis as the presenting feature of Kawasaki disease.急性前葡萄膜炎作为川崎病的首发特征
Indian J Pediatr. 2014 Apr;81(4):415. doi: 10.1007/s12098-014-1367-x. Epub 2014 Feb 25.
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Pediatric vasculitis.儿科血管炎。
Pediatr Clin North Am. 2012 Apr;59(2):407-23. doi: 10.1016/j.pcl.2012.03.013. Epub 2012 Apr 6.

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