婴儿川崎病64例临床分析

REVIEW OF INFANT KAWASAKI DISEASE:A REPORT OF 64 CASES

目的总结婴儿川崎病(Kawasaki disease KD)的临床特点以利于早期诊断治疗。方法回顾性分析我院1997年1月—2005年12月诊治的婴儿KD64例临床资料,并与同时期诊治的幼儿KD70例对比分析。结果婴儿KD男女比例1.29∶1,主要临床表现发生率与幼儿KD无区别,血小板数及白细胞总数明显升高,白细胞总数>30×109/L病例明显增多,贫血患儿明显增多,冠脉扩张、肺血管炎改变显著增多,消化系统紊乱显著增多差异均有统计学意义(P<0.05);血沉(ESR)、C-反应蛋白(CRP)明显升高与幼儿KD比较差异无统计学意义;确诊时间明显延长(P<0.05)。结论婴儿KD临床表现无特异性,对发热持续时间长,白细胞明显升高,抗感染治疗无效时应提高警惕,及早做超声心动图检查冠状动脉及ESR、CRP,动态观察血小板变化,有助于早期诊断。

Objective To analyze the clinical feature of infant with Kawasaki Disease （KD）. Methods The date of 64 cases with infant KD admitted from January of 1997 to December of 2005 were analyzed retrospectively. Compare was made between values of infant KD and those of 70 cases with child KD. Results Male - female ratio of infant KD was 1.29 ： 1. Compared values of infant KD with those of child KD, there was no significant difference in the incidence of the most common clinical features, while the number of leucocyte and platelet was statistically higher （P〈0. 05）. Number of cases with more than 30 × 10^9/L leucocyte was statistically increased （P〈0. 05）, anaemia was more common in infant KDs （P〈0.05）, coronary artery abnormalities and lung blood vessel pathological changes were strengthened （P〈0.05）, disorder of digestive system occurred more frequently （P〈0. 05）, in addition, the time in diagnosis of infant kawasaki disease was statistically delaied. Conclusion Attention should be aroused to the infants with fever lasting longer than 5 days and leucocyte number increasing if treatment shows no effect. Therefore, they are helpful for early diagnosis such as intime examine of coronary artery abnormalities, ESR and CRP, especially platelet change.