川崎病临床特点分析

Clinical Analysis of Kawasaki Disease

目的总结川崎病(KD)的临床特征,探讨KD的诊断和治疗。方法回顾性分析2002年11月—2009年11月300例KD住院患儿的临床资料,比较无冠状动脉损害与有冠状动脉损害患儿的临床特征及实验室检查结果。结果无冠状动脉损害组患儿皮疹较有冠状动脉损害组明显增多,差异有统计学意义(P<0.05);两组持续发热、球结膜充血、口腔黏膜变化、颈部淋巴结肿大、手足变化、肛周潮红脱屑比较,差异均无统计学意义(P>0.05)。无冠状动脉损害组患儿血红蛋白较有冠状动脉损害组明显升高,差异有统计学意义(P<0.05);无冠状动脉损害组患儿血小板计数较有冠状动脉损害组明显降低,差异有统计学意义(P<0.05);两组心电图表现、红细胞比容、白细胞计数、C反应蛋白、红细胞沉降率、总蛋白、清蛋白及乳酸脱氢酶比较,差异均无统计学意义(P>0.05)。结论 KD患儿以发热、皮疹、球结膜充血等为主要表现,彩色超声心动图对诊断KD并冠状动脉损害有重要价值,血红蛋白下降及血小板计数升高可作为KD并发冠状动脉损害的高危因素。

Objective To summarize the clinical features,diagnosis,and treatment of Kawasaki disease（KD）.Methods The clinical data of 300 pediatric patients with KD were retrospectively analyzed,and the clinical feature and laboratory results were compared between patients with non-coronary artery lesion（N-CAL）and those with coronary artery lesion（CAL）.Results The incidence of skin rash was significantly higher in N-CAL group than in CAL group（P〈0.05）.Other clinical findings including persistent fever,bulbar conjunctiva hyperemia,changes of oral mucous membrane,cervical lymphadenectasis,changes in feet and hands,and flushing and desquamation at crissum were not significantly different between N-CAL group and CAL group（all P〈0.05）.Hemoglobin level was significantly increased in N-CAL group than in CAL group（P〈0.05）.The platelet amount was significantly lower in N-CAL group than in CAL group（P〈0.05）.However,the electrocardiogram findings,hematocrit value,white blood cell count,C-creative protein,erythrocyte sedimentation rate,total protein,albumin,and lactate dehydrogenase were not significantly different between these two groups（all P〈0.05）.Conclusion The main clinical manifestations of KD in pediatric patients include fever,skin rash,and bulbar conjunctiva hyperemia.Color enchocardiogram is useful for the diagnosis of KD-associated coronary lesions.Elevated platelet and low hemoglobin are the high-risk factors of CAL in KD.