■探讨川崎病合并髋关节滑膜炎的临床特点及危险因素。回顾性纳入温州医科大学附属育英儿童医院KD数据库中
■2011年1月1日至2020年12月31日收治的KD患儿。选取KD合并髋关节滑膜炎患儿为病例组,KD无髋关节滑膜炎患儿为对照组,分析KD患儿发生髋关节滑膜炎的可能危险因素。
■近年来,在我们中心收治的2,871名KD儿童中,28例患有髋关节滑膜炎。在这项研究中,140名KD儿童被登记,包括28例KD型髋关节滑膜炎患儿和112例一般KD患儿(入院后1个月内)。KD合并髋关节滑膜炎患者的发病年龄为30.92(23.23-49.99)个月,双侧髋关节受累17例。滑膜炎的过程(有限的运动,关节痛,跛行,不愿站,等。)范围从1天到19天,平均(8.8±4.6)天。我们用IVIG(静脉免疫球蛋白)加阿司匹林治疗所有KD儿童,其中病例组中有5例发生冠状动脉损伤,六个获得的IVIG抗性,滑膜炎症在两周内消失。年龄,体重,逗留时间,和IVIG抵抗的发生率在两组之间显着差异(分别为P=0.001、0.005、<0.001和0.035)。Logistic回归分析显示,KD合并髋关节滑膜炎是发生丙粒耐药的独立危险因素,OR值为4.625(95%CI:1.095,19.526)。
■KD合并髋关节滑膜炎主要累及双侧髋关节,关节疼痛和活动受限是主要临床特征。症状是轻微的和自限性的。KD合并髋关节滑膜炎是IVIG抵抗的危险因素。髋关节滑膜炎是IVIG抵抗的良好预测指标。
UNASSIGNED: To investigate the clinical characteristics and risk factors of Kawasaki disease (KD) complicated with hip synovitis.
UNASSIGNED: Children with KD admitted from January 1, 2011, to December 31, 2020, in the KD database of Yuying Children\'s Hospital Affiliated with Wenzhou Medical University were retrospectively included. We selected KD children with hip synovitis as the case group and KD children without hip synovitis as the control group to analyze the possible risk factors of hip synovitis in KD children.
UNASSIGNED: Among 2,871 KD children admitted to our center in recent years, 28 had hip synovitis. In this study 140 KD children were enrolled, including 28 KD children with hip synovitis and 112 children with general KD (within one month of admission). The onset age of KD patients with hip synovitis was 30.92 (23.23-49.99) months, and there were 17 cases of bilateral hip involvement. The course of synovitis (limited movement, joint pain, lameness, unwillingness to stand, etc.) ranged from 1 to 19 days, with an average of (8.8 ± 4.6) days. We treated all KD children with IVIG (Intravenous immunoglobulin) plus aspirin, among which five patients in the case group developed coronary artery damage, six acquired IVIG resistance, and synovial inflammation disappeared within two weeks. Age, weight, length of stay, and incidence of IVIG resistance significantly differed between the two groups (P = 0.001, 0.005, <0.001, and 0.035, respectively). Logistic regression analysis showed that KD combined with hip synovitis was an independent risk factor for developing propyl pellet resistance, with an OR value of 4.625 (95% CI: 1.095, 19.526).
UNASSIGNED: KD combined with hip synovitis mainly involves bilateral hip joints, and joint pain and limited movement are the main clinical features. The symptoms are mild and self-limiting. KD combined with hip synovitis is a risk factor for IVIG resistance. Hip synovitis is a good predictor of IVIG resistance.