目的 探讨血沉(ESR)对川崎病(KD)冠状动脉病变(CAL)的预测价值。方法 收集 2017 年 5 月— 2021 年 6 月收治入院的KD患儿的临床资料,分析ESR对KD患儿CAL发生的预测作用。结果 纳入272例KD患儿,70例KD患儿合并CAL,202例KD患儿无CAL。KD患儿的ESR升高。单因素分析提示CAL组的ESR低于非CAL组,差异有统计学意义(P＜0.05)。ROC曲线下的面积为0.586,提示ESR可作为CAL的预测因子(P＜0.05)。ESR预测川崎病冠脉病变发生的临界值为76.5 mm/h。二分类Logistic回归分析显示,ESR是KD患儿发生CAL的独立危险因素(P＜0.05),当ESR＜76.5 mm·h^-1时,KD患儿CAL发生风险增加 (OR=2.38,95% CI: 1.25~4.53)。结论 KD急性期的ESR水平可用于预测KD患儿CAL的发生,ESR＜76.5 mm·h^-1时,提示KD患儿可能会出现CAL。

Objective To investigate the predictive value of erythrocyte sedimentation rate (ESR) on coronary artery lesions (CAL) in Kawasaki disease (KD). Methods Clinical data of children with KD admitted to the hospital from May 2017 to June 2021 were collected to analyze the predictive value of ESR on the occurrence of CAL in children with KD. Results Of the 272 enrolled children with KD, 70 children with CAL and 202 children without CAL. ESR was significantly higher in children with KD. Univariate analysis suggested that ESR was lower in the CAL group than in the non-CAL group, and the difference was statistically significant (P<0.05). The area under the ROC curve was 0.586, suggesting that ESR could be a predictor of CAL (P<0.05). The critical value of ESR for predicting the occurrence of CAL in KD was 76.5 mm/h. Dichotomous Logistic regression analysis showed that ESR was an independent risk factor for the development of CAL in children with KD (P<0.05), and the risk of CAL in children with KD was significantly increased when ESR was<76.5 mm/h. (OR = 2.38, 95% CI: 1.25-4.53). Conclusions ESR levels in the acute phase of KD can be used to predict the development of CAL in children with KD, and ESR <76.5 mm/h suggests that children with KD may develop CAL.

目的 探讨血常规、血沉、C-反应蛋白水平对小儿急性肺炎的诊断价值。方法 选取2014年1月—2019年12月我院收治的小儿急性肺炎100例作为研究组,同时根据有无发生感染将其分为感染组(26例)与非感染组(74例),另外选择同期在我院检查的健康儿童100例作为对照组。比较感染组与非感染组血常规、血沉、C-反应蛋白水平、感染组与对照组血常规、血沉、C-反应蛋白水平、非感染组与对照组血常规、血沉、C-反应蛋白水平。结果 感染组中性粒细胞百分比、白细胞计数、C-反应蛋白高于非感染组(P＜0.05),两组血沉对比,无明显差异(P＞0.05);感染组中性粒细胞百分比、白细胞计数、C-反应蛋白、血沉高于对照组(P＜0.05);两组中性粒细胞百分比、C-反应蛋白水平相比,无明显差异(P＞0.05),非感染组白细胞计数、血沉高于对照组(P＜0.05)。结论 小儿急性肺炎的诊断中,对小儿的血常规、血沉、C-反应蛋白水平进行检测对诊断疾病非常重要,值得临床使用。

Objective To investigate the diagnostic value of blood routine, erythrocyte sedimentation rate and C-reactive protein level in children with acute pneumonia. Methods A total of 100 cases of acute pneumonia in children admitted to our hospital from January 2014 to December 2019 were selected as the study group. At the same time, they were divided into an infected group (26 cases) and a non-infected group (74 cases) according to the presence or absence of infection. In addition, 100 healthy children examined in our hospital during the same period were selected as the control group. Blood routine examination, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level were compared between infected and non-infected group; in infection and control group blood routine examination, ESR, C-reactive protein level were compared; in non-infection and control group blood routine examination, ESR, C-reactive protein level were compared. Results The percentage of neutrophils, white blood cell count and C-reactive protein in the infected group were higher than those in the non-infected group (P<0.05). There was no significant difference in erythrocyte sedimentation rate between the two groups (P> 0.05). The percentage of neutrophils, leukocyte count, C-reactive protein and erythrocyte sedimentation rate in the infected group were higher than those in the control group (P<0.05). There was no significant difference in the percentage of neutrophils and C-reactive protein levels between the two groups (P> 0.05), and the white blood cell count and erythrocyte sedimentation rate in the non-infected group were higher than those in the control group (P<0.05). Conclusion In the diagnosis of acute pneumonia in children, it is very important to detect the blood routine, erythrocyte sedimentation rate and C-reactive protein level in children, and it is worthy of clinical use.