川崎病101例临床及随访分析

Clinical Analysis and follow-up observation of 101 cases of Kawasaki disease

目的总结川崎病(KD)病例临床诊治及随访经验。方法对2008年1月～2008年12月我科诊治的101例川崎病临床特征和治疗转归及随访治疗进行回顾性分析,随访时间最长1年10月。本文病例中60例(A组)选用静脉丙种球蛋白加口服阿司匹林治疗;41例(B组)选用阿司匹林治疗。并发无菌性脑膜炎者短期应用甘露醇脱水及激素治疗。结果我科住院的101例川崎病病病例经积极治疗,临床症状消失出院。A组出院时发生冠状动脉病变33例(55.0%),失访1例;B组发生冠状动脉病变16例(39.0%),KD并发无菌性脑膜炎为KD的重症病例,本文12例并发无菌性脑炎中同时并发冠状动脉病变11例(91.7%)。结论近年KD有增多趋势,不完全KD及并发无菌性脑膜炎的病例数有增多趋势,临床应引起重视。去除并发无菌性脑膜炎病例数,A、B两组并发冠状动脉病变相比,χ2=0.51,p>0.05,无显著差异。儿科医师要提高对KD的认识,早期诊断、早期治疗是减少、减轻KD并发冠状动脉病变的关键。

Objective To summarize the experience of clinical diagnosis, treatment and follow - up of Kawasaki disease. Methods The clinical characteristics, treatment and follow - up of 101 cases of Kawasaki disease in 2008 were analyzed retrospectively. 60 cases were treated with intravenous gamma globulin and aspirin; 41 cases were only treated with aspirin. The patients with aseptic meningitis were treated with mannitol and dexamethasone. Results The clinical symptoms of all the cases were improved after treatment. There were 33 cases of KD in A group and 16 cases in B group with lesion of coronary arterial ; and 11 cases with coronary arterial lesion in 12 cases of KD with aseptic meningitis. Conclusion It is worthwhile to pay more attention to the increase of KD complicated with aseptic meningitis and incomplete KD. It is very important to improve early diagnosis and treatment in order to decreasing the incidence of coronary arterial lesion.