Clinical characteristics of Kawasaki disease complicated with Mycoplasma pneumoniae pneumonia A retrospective study
Clinical characteristics of Kawasaki disease complicated with Mycoplasma pneumoniae pneumonia A retrospective study
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DOI：
10.1097/md.0000000000019987
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发表时间：
2020-05-01
期刊：
影响因子：
1.6
通讯作者：
Chen, Zhimin
中科院分区：
文献类型：
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作者：
Lan, Yinle;Li, Shuxian;Chen, Zhimin
本研究旨在探讨肺炎支原体（MP）感染与川崎（KD）的内在联系、发病机制及影响预后的危险因素。对2014年1月至2017年12月浙江大学医学院附属儿童医院确诊的210例KD合并社区获得性肺炎（CAP）患者进行回顾性研究。根据MP感染情况将其分为两组：MP感染组（n = 97）和非MP感染组（n = 113）。比较两组患者的临床资料。MP感染组ESR高于非MP感染组。在住院期间，与MP感染组相比，非MP感染组在住院期间的WBC、LDH、PCT水平较高，HB水平较低。MP感染组与非MP感染组的hs-CRP水平、N%、PLT、ALT、CKMB和细胞因子水平（IL-2、IL-4、IL-6、IL-10、TNF-α和IFN-γ）无差异。同样，他们之间的发热持续时间或住院时间也没有差异。感染组中CAA发生率为19.59%，非MP感染组中CAA发生率为23.89%。不幸的是，两组之间的CAA率没有差异。MP感染可同时发生在川崎患儿中。合并MP感染的KD患者多发生于老年人群。MP感染可能不会增加CAA的风险，这还需要进一步的大规模研究来证实。临床医生应警惕血沉升高的KD患者。对MP应进行筛查，早期及时给予大环内酯类药物治疗。
This study aimed to investigate the inner linkage and mechanism ofMycoplasma pneumoniae(MP) infection and Kawasaki disease (KD), as well as the risk factors of outcome in this cohort of patients. A retrospective study was performed in 210 patients diagnosed with KD complicated with community acquired pneumonia (CAP) in Children's Hospital, Zhejiang University School of Medicine from January 2014 to December 2017. They were divided into two groups based on MP infection: MP infection group (n = 97) and non-MP infection group (n = 113). We compared the variables of these two groups based on medical records. The MP infection group had higher ESR than the non-MP infection group. During hospitalization, the non-MP infection group had higher levels of WBC during hospital, LDH, PCT, and lower HB when compared to the MP infection group. No differences were found in the hs-CRP level, N%, PLT, ALT, CKMB, and cytokine levels (IL-2, IL-4, IL-6, IL-10, TNF-alpha, and IFN-gamma) between MP and non-MP infection group. Likewise, no difference was found in fever duration or hospital stays between them. Totally 19 patients in the infection group had CAA with a rate of 19.59%; and 27 (23.89%) patients had CAA in the non-MP infection group. Unfortunately, no difference was found in CAA rate between the two groups. MP infection may occur simultaneously in children with Kawasaki disease. KD patients with MP infection tended to occur in older population. MP infection may not increase the risk of CAA, which still needs further large-scaled studies to confirm. Clinicians should be alert to KD patients with high level of ESR. MP should be screened and early treatment with macrolides should be given timely.