小儿不完全川崎病22例临床分析

A clinic analysis of 22 cases of incomplete infantile kawasaki disease

目的:探讨小儿不完全川崎病的早期诊断,以及早期进行冠状动脉病变的预防治疗,减少冠状动脉瘤的发生。方法:分析2001年5月至2007年10月收住院的小儿不完全川崎病22例的临床特征、实验室检查并进行讨论。结果:全部病例在恢复期均出现指(趾)端脱皮,入院时22例患儿中9例具备包括持续发热在内的2条诊断指标,8例具备包括持续发热在内的3条诊断指标,5例具备包括持续发热在内的4条诊断指标及外周血白细胞(WBC)、C反应蛋白(CRP)、血小板升高,血沉增快;21例冠状动脉扩张、1例有冠状动脉瘤的形成。结论:小儿不完全川崎病因早期临床表现不典型,应对持续发热>5d、抗生素治疗无效的病例进行动态超声心动图检查及随访CRP、血沉、WBC计数,作出早期诊断,减少冠状动脉病变。

Objective： Explore how to diagnose the incomplete Kawasaki disease and preventively treat the pathological changes of coronary artery in an earlier stage, so as to reduce the incidence of coronary artery tumor. Method： Make an analysis of the clinic symptoms, lab findings and then hold a discussion concerning the 22 cases of patients hospitalized, for the incomplete Kawasaki disease, from May 2001 to October 2007. Result： All the patients in recuperating period had their fingertips or toe-ends desquamated. Upon hospitalization, 9 of the 22 patients had two diagnostic indicators including sustaining fever; 8 of the 22 patients had three diagnostic indicators including sustaining fever; 5 of them had four diagnostic indicators including sustaining fever and WBC, CRP, rise of blood platelet, quickened subsiding of blood; 21 of them had coronary artery dilated; and one of them had coronary artery tumor formed. Conclusion： As the earlier-stage clinic manifestations of the incomplete Kawasaki disease were not typical, the patients, who had sustaining fever 〉5d and failed to be cured by antibiotics, should be cbecked up through dynamic ultrasonic heart-beat graph and by tracking CPR, blood subsiding, and WBC digits, so as to have an earlier diagnosis and reduce pathological changes in coronary artery.