| 摘要: |
| 目的:比较不完全川崎病(IKD)和典型川崎病(CKD)的临床特征,提高临床医师对IKD的认识,从而降低误诊率。方法:回顾性分析2004年1月至2013年12月在十堰市中医院住院的105例川崎病患儿临床资料,包括80例CKD和25例IKD,比较分析IKD组和CKD组患儿临床特点、实验室检查、脏器损害情况、诊断时间及住院时间等。结果:两组患儿性别和年龄比较差异无统计学意义(P>0.05),但在<1岁年龄段患儿例数比较差异有统计学意义(χ2=5.47,P<0.05);与CKD组比较,IKD组口腔黏膜病变、指趾脱皮、皮疹、肛周潮红脱皮及颈部淋巴结肿大的发生率降低(χ2分别为6.11、16.51、15.80、9.14、9.88,P<0.05 或P<0.01);两组白细胞(WBC)计数、红细胞比容(HCT)、最大血小板(PLTmax)计数、C反应蛋白(CRP)水平、血沉(ESR)、白蛋白(ALB)水平比较差异均无统计学意义(P>0.05);IKD组冠状动脉扩张(CAD)、瓣膜反流、心电图异常发生率高于CKD组(χ2分别为13.22、4.14、3.96,P<0.05 或P<0.01);IKD组诊断时间和住院时间分别为(6.25±3.05)d 和(13.85±5.10)d,长于CKD组的(4.50±2.25)d 和(11.25±4.50)d(t分别为3.11、2.44,P<0.05 或P<0.01),所有KD患儿经静脉滴注丙种球蛋白(IVIG)和口服阿司匹林治疗,均治愈或好转。结论:IKD患儿临床表现不典型,实验室检查与CKD患儿无明显差异,冠状动脉病变(CAL)发生率较CKD高。临床医师应结合实验室检查及心脏影像学检查,及早诊断和治疗。 |
| 关键词: 不完全川崎病 典型川崎病 临床特征 冠状动脉损害 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2017.06.009 |
|
| 基金项目: |
|
| Retrospective Analysis of 105 Kawasaki Disease in Children |
| Lu Guangquan1,2 , Li Rugui1 |
| (1. People's Hospital Affiliated to Hubei University of Medicine, Hubei Shiyan 442000, China 2. Shiyan Traditional Chinese Medicine Hospital, Hubei Shiyan 442000, China) |
| Abstract: |
| Objective: To compare the clinical characteristics of incomplete Kawasaki disease (IKD) and complete Kawasaki disease (CKD), to improve the awareness about IKD and decrease misdiagnosis rate of IKD. Methods: The clinical data of 105 children with Kawasaki disease in Shiyan Traditional Chinese Medicine Hospital from January 2004 to December 2013 were analyzed retrospectively, 80 cases were CKD and 25 cases were IKD. The clinical characteristics, laboratory examination, organ damage, diagnosis time and hospitalization time between the two groups were compared and analyzed. Results: There were no significant differences in gender and age (P>0.05), but there was significant difference in age <1 year between the two groups (χ2=5.47, P<0.05). Compared with CKD group, the incidences of oral mucosal lesions, finger toe peeling, skin rash, perianal desquamation and lymph node enlargement in IKD group decreased (χ2=6.11, 16.51, 15.80, 9.14, 9.88, P<0.05 or P<0.01). The laboratory examinations including white blood cell (WBC), hematocrit (HCT), maximum platelet (PLT) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin (ALB) had no statistical significance differences between two groups (P>0.05). The incidences of coronary artery dilation (CAD), valvular regurgitation, ECG abnormal in IKD group were higher than those in CKD group (χ2 =13.22, 4.14, 3.96, P<0.05 or P<0.01). The diagnostic time and hospitalization time in IKD group were (6.25±3.05) d and (13.85±5.10) d, which were higher than (4.50±2.25) d and (11.25±4.50) d in CKD group (t=3.11, 2.44, P<0.05 or P<0.01). All KD children were cured or improved by immunoglobulin (IVIG) and aspirin treatment. Conclusion: The clinical manifestations of IKD are atypical, there is no significant difference comparing with CKD in laboratory examinations, and the incidence of coronary artery disease (CAL) is higher than that of CKD. Clinicians should give early diagnosis and treatment as soon as possible under laboratory and cardiac imaging examination. |
| Key words: incomplete Kawasaki disease complete Kawasaki disease clinical characteristics coronary artery lesion |
