60例不典型川崎病的临床诊断分析

Clinical diagnostic analysis of 60 cases of atypical kawasaki disease

目的：探讨不典型川崎病的临床特点，为临床早期诊断提供参考。方法回顾性分析60例不典型川崎病患儿的临床资料。结果患儿年龄分布以1～3岁居多，占71．67％；发热时间以5～10 d为主，占68．33％；确诊时间以＞5 d为主，占65．00％；症状及体征中，发热时间＞5 d、眼结膜充血及口腔粘膜改变发生率最高，依次为98．33％、91．67％、81．67％；入院时实验室检查项目中血沉（ ESR）增快、白细胞（ WBC）升高、C反应蛋白（ CRP）升高、血红蛋白（ Hb）降低、白蛋白降低、血小板（PLT）升高、血钠降低、血钾降低阳性率分别为88．33％、85．00％、81．67％、80．00％、56．67％、48．33％、43．33％、25．00％。结论不典型川崎病早期临床症状及体征缺乏特征性，原因不明的发热患儿应及早行实验室检查，根据其阳性项目结合症状及体征进行诊断。

Objective To discuss the clinical characteristics of atypical kawasaki disease and provide reference for clinical di -agnosis and treatment .Methods Clinical data of 60 cases of atypical kawasaki disease was retrospectively analyzed .Results The age distribution of the patients was mostly 1 to 3 years, accounting for 68.33%, and the confirmed time was 〉5 days, accounting for 65.00%.In signs and symptoms,the rates of fever time 〉5 days,eye conjunctival congestion and oral cavity mucous membrane chan -ges were 98.33%,91.67%and 81.67% respectively, standing the highest of all .The positive rates of laboratory tests on admission such as elevated blood sedimentation （ESR）,elevated white blood cells （WBC）,elevated c-reactive protein （CRP）,reduced hemoglo-bin （HB）,albumin,elevated platelets （PLT）,reduced serum sodium,reduced potassium were 88.33%,85.00%,81.67%,80.00%, 56.67%,48.33%,43.33%,25.00% respectively.Conclusion The primary clinical symptoms and signs of the patients of atypical kawasaki disease are not characteristic ,and children patients with fever of unknown origin should undertake laboratory examinations as early as possible , upon which clinical diagnosis should be made .