Detection rate and clinical impact of respiratory viruses in children with Kawasaki disease.
Detection rate and clinical impact of respiratory viruses in children with Kawasaki disease.
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DOI：
10.3345/kjp.2012.55.12.470
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发表时间：
2012-12
影响因子：
--
通讯作者：
Ko JK
中科院分区：
文献类型：
--
作者：
Kim JH;Yu JJ;Lee J;Kim MN;Ko HK;Choi HS;Kim YH;Ko JK
本前瞻性病例对照研究的目的是应用多重逆转录聚合酶链反应（RT-PCR）技术调查川崎病（KD）患儿呼吸道病毒检出率，探讨川崎病急性期呼吸道病毒流行的临床意义。采用RT-PCR检测55例KD患者和78例对照者鼻咽分泌物中呼吸道合胞病毒A、B、腺病毒、鼻病毒、副流感病毒1 ~ 4、流感病毒A、B、偏肺病毒、bocavavirus、冠状病毒OC43/229E和NL63、肠病毒的存在。KD患者和对照组的病毒检出率分别为32.7%和30.8% （P=0.811）。然而，这15种病毒中的任何一种的存在与KD的发病率之间没有显著的关联。将18例RT-PCR结果阳性的患者与其他37例KD患者进行比较，发现在临床表现（包括疾病不完全表现的患病率）和冠状动脉直径方面没有显著差异。当前流行的呼吸道病毒RT-PCR阳性不应作为反对KD诊断的证据。这些病毒与KD的不完全表现和冠状动脉扩张无关。
The purpose of this prospective case-control study was to survey the detection rate of respiratory viruses in children with Kawasaki disease (KD) by using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), and to investigate the clinical implications of the prevalence of respiratory viruses during the acute phase of KD. RT-PCR assays were carried out to screen for the presence of respiratory syncytial virus A and B, adenovirus, rhinovirus, parainfluenza viruses 1 to 4, influenza virus A and B, metapneumovirus, bocavirus, coronavirus OC43/229E and NL63, and enterovirus in nasopharyngeal secretions of 55 KD patients and 78 control subjects. Virus detection rates in KD patients and control subjects were 32.7% and 30.8%, respectively (P=0.811). However, there was no significant association between the presence of any of the 15 viruses and the incidence of KD. Comparisons between the 18 patients with positive RT-PCR results and the other 37 KD patients revealed no significant differences in terms of clinical findings (including the prevalence of incomplete presentation of the disease) and coronary artery diameter. A positive RT-PCR for currently epidemic respiratory viruses should not be used as an evidence against the diagnosis of KD. These viruses were not associated with the incomplete presentation of KD and coronary artery dilatation.