小儿不典型川畸病的早期诊断

Children are not typical of early diagnosis of kawasaki disease

目的:探讨不典型川崎病的早期临床诊断策略。方法:对2006年12月～2009年12月住院的不典型川崎病28例患儿的临床特征和诊治过程,进行分析讨论。结果:入院时28例患儿中17例具备包括持续发热在内的川畸病3条诊断指标,11例具备包括持续发热在内的川崎病4条诊断指标及外周血WBC、CRP、血小板增高,血沉增快;28例在恢复期均出现指(趾)端脱皮,其中12例有冠状动脉扩张,均无冠状动脉瘤的形成。结论:对持续发热5d以上,具有包括发热在内的3条或4条诊断指标,同时具备外周血WBC、CRP、血沉、血小板增高,提示川崎病。排除其他疾病后,即使达不到川畸病的诊断标准,亦应及早应用丙种球蛋白,以预防冠状动脉病变的发生。

Objective：To investigate the atypical early diagnosis of kawasaki disease strategy.Methods：Dec.2006 to Dec. 2009 hospitalized with atypical clinical features of 28 cases with kawasaki disease and treatment process were discussed. Results：28 patients on admission in children include persistent fever with 17 cases,including three diagnostic indicators,including 11 cases of continued fever with kawasaki disease,including 4 diagnostic index and peripheral blood WBC,CRP, platelets,ESR increase fast;28 patients were in recovery appears that （toe） end of peeling,in which 12 patients had coronary artery dilatation,no coronary aneurysm formation.Conclusion：Persistent fever for more than 5 days,with,including fever,including three or four diagnostic indicators,with peripheral WBC,CRP,ESR,platelets,suggesting that kawasaki disease.After the exclusion of other diseases,if not meet diagnostic criteria for kawasaki disease, early application of gamma globulin should be to prevent the occurrence of coronary artery disease.