6月龄以下小婴儿川崎病55例临床分析

Clinical analysis of 55 infants under six months with Kawasaki disease

目的:分析0～6月龄婴儿川崎病(KD)的临床特点。方法:收集2001年1月～2011年12月≤6月龄KD患儿55例,≤6月龄组又分为冠状动脉病变组(CAL)和冠状动脉正常组(NCAL),并于同期收治的>6月龄KD患儿452例进行比较。结果:球结膜充血率、口唇改变率、颈部淋巴结肿大率、不完全KD率、冠脉改变率,≤6月龄组明显低于>6月龄组(P<0.05)。≤6月龄组川崎病患儿临床症状不典型,球结膜充血,颈部淋巴结及口唇改变少见,确诊时间长,不完全KD的发病率及冠脉损害率明显升高;C反应蛋白、血沉、清蛋白、发热时间、白细胞计数、血小板计数、≤6月龄的CAL组与NCAL相比均无统计学差异(P>0.05)。CAL组的粒细胞数胆显高于NCAL组(P<0.05)。结论:6个月内小婴儿由于临床症状不典型,不完全KD及冠脉损害率升高明显,诊断困难,其冠脉的发生率与粒细胞升高有关。

Objective： To analyze the clinical characteristics of 0 - 6 - month infants with Kawasaki disease （KD） . Methods： A total of fifty - five 0 - 6 - month infants with KD were collected from January 2001 to December 2011, then they were divided into coronary artery lesion group and normal coronary artery group, 452 infants more than six months with KD during the same period were selected as control group. Results ： The incidences of bulbar conjunctiva hyperemia, oral lip change, swelling of lymph nodes of neck, incomplete KD, coronary artery change in ≤6 - month group were significantly lower than those in 〉 6 - month group （ P 〈 0. 05 ） . The clinical symptoms of ≤6 - month infants with KD were not typical, bulbar conjunctiva hyperemia, changes of oral lip and lymph nodes of neck were not common, the time for definite diagnosis was long, the incidences of incomplete KD and coronary artery lesion indreased significantly; there was no significant difference in the C reactive protein level, erythrocyte sedimentation rate, albumin level, fever time, white blood cell count, platelet count between coronary artery lesion group and normal coronary artery group （P 〉 0. 05） . The number of granulocytes in coronary artery lesion group was significantly higher than that in normal coronary artery group （P 〈 0. 05） . Conclusion： KD diagnosis among the infants under six months is difficult because of the atypical clinical symptoms and obvious increases of incidences of incomplete KD and coronary artery lesion, the incidence of coronary artery lesion is related to the increase of granulocytes.