川崎病与不完全性川崎病临床特点的比较分析:多中心观察性研究

Comparision of Incomplete Kawasaki disease and Kawasaki disease: a multi-center observational study

目的比较川崎病(KD)与不完全川崎病(iKD)临床特点差异。方法通过多中心观察性研究,收集2007年至2012年湖州市第一人民医院,辽河油田中心医院,慈溪市人民医院3家三甲医院收治的234例KD患儿及48例iKD患儿临床资料。分析其临床特点和转归情况,比较两者临床特点差异。结果 KD组患儿手足硬肿、指趾端脱皮、多形性红斑、眼结膜充血、口唇充血皲裂、草莓舌、颈部淋巴结肿大发生率均明显高于iKD组(P均<0.05),且KD组患儿以发热、球结合膜充血最常见,而iKD组主要为指趾端脱皮及手足硬肿。KD组患儿中血红蛋白下降者及白细胞增多者比例高于iKD组,iKD组患儿中心肌酶升高者比例高于KD组(P均<0.01)。KD组患儿多以多形性红斑为首发症状,而iKD较早出现的症状为球结合膜充血。iKD组患儿心电图检查示急性期窦性心动过速者比例高于KD组(P<0.01)。iKD组对IVIG治疗不敏感者比例高于KD组(P<0.01)。结论 KD和iKD在临床表现和预后不尽相同,在诊疗是应积极分开对待。

Objective To compare the difference of clinical features between Kawasaki disease （KD）and incomplete Kawasaki disease （iKD）.Methods In this multicenter study,234 cases of KD and 48 cases of iKD from January 2007 to December 201 2 were collected in the First People’s Hospital of Huzhou City, Liaohe Oilfield Central Hospital and People’s Hospital of Cixi City.The clinical features of KD and iKD were analyzed and compared.Results The incidence of children with hand,foot hard swollen,peelings in fingers and toes,erythema multiforme,conjunctival hyperemia,congestion and chapped lips,strawberry tongue,cer-vical lymph nodes in KD group was significantly higher than that in iKD group （P〈0.05）.Fever and ball conjunctival hyperemia were the most common symptoms in KD group.And major manifestations in iKD group were fingers and toes end peeling and swelling of hands and feet,while other symptoms were relatively rare.In addition,most children in KD group presented erythema multiforme as the first symptom,while the earlier symptom of iKD was ball conjunctival hyperemia.The incidences of hemoglobin decrease and leukocytosis in KD group were significantly higher than those in iKD group.The abnormal level of CK-MB in iKD group ap-peared significantly higher than that in KD.Abnormal ECG was more frequently observed in iKD group.The ratio of no response to IVIG therapy in iKD group was higher than that in KD Group.Conclusions The clini-cal manifestations and prognosis varied between KD and iKD,which should be treated separately.