目的 探讨丙种球蛋白非敏感型川崎病早期实验室检查中的危险指标.方法 回顾性分析2015年7月1日至2016年6月30日881例川崎病患儿的临床资料,其中丙种球蛋白非敏感型患儿26例(A组),一般型855例(B组).通过以年龄、性别1:3为匹配条件的logistic回归分析,构建各变量[性别、月龄、发热天数、体温、红细胞计数(RBC)、白细胞计数(WBC)、中性粒细胞(N)、淋巴细胞(L)、血小板计数(PLT)、C反应蛋白(CRP)]的回归模型.结果 与B组相比,A组的RBC计数较低,PLT较高,差异均有统计学意义(P<0.05).以月龄为条件logistic回归分析回归模型为Y=-2.87+0.01×PLT(PLT:OR=1.01,95％CI:1.00～1.01,P<0.01),以性别为条件logistic回归分析回归模型为Y=-32.98+0.44×WBC+0.28×N+0.01×PLT(WBC:OR=1.55,95％CI:1.17～2.05,P<0.01;N％:OR=1.32,95％CI:1.04～1.68,P<0.05;PLT:OR=1.01,95％CI:1.00～1.01,P<0.01).结论 确诊川崎病时伴随PLT水平异常增高,需要警惕丙种球蛋白无反应型的可能.%Objective To explore the early laboratory indicators for risk of intravenous immunoglobin-resistant Kawasaki diseases. Methods The clinical data were retrospectively analyzed in 881 Kawasaki disease patients (group A: 26 cases of intravenous immunoglobin-resistant; group B: 855 cases of intravenous immunoglobin-sensitive) from July 1, 2015 to June 30, 2016. After 1:3 matching with age and sex, the regression model for each of variables including sex, age, fever days, temperature, red blood cell count (RBC), white blood cell count (WBC), neutrophil (N), lymphocyte (L), platelet count (PLT) and C reactive protein (CRP), was constructed by conditional logistic regression analysis. Results Compared with group B, group A had significantly lower RBC count and higher PLT (P<0.05). Logistic regression analysis showed that, with the age, the regression model was Y=-2.87+0.01×PLT (PLT OR=1.01, 95％ CI: 1.00～1.01, P<0.01); with the sex, Y=-32.98+0.44×WBC+0.28× N+0.01×PLT (WBC OR=1.55, 95％ CI: 1.17～2.05, P<0.01; N％ OR=1.32, 95％ CI: 1.04～1.68, P<0.05; PLT OR=1.01, 95％ CI 1.00～1.01, P<0.01). Conclusion In case that abnormally high levels of PLT exist in confirmed Kawasaki disease, it should be aware of possibility of the intravenous immunoglobin-resistant Kawasaki disease.
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