不同类型川崎病临床特征比较分析

Clinical Features Analysis of Different Types Kawasaki Disease

目的:比较分析典型川崎病(CKD)和不完全型川崎病(IKD)的临床特征,探讨IKD的诊治方法。方法:采用回顾性研究方法,选取我院2014年1月至2016年3月收治的67例CKD患儿(CKD组)和26例IKD患儿(IKD组),分析其临床表现、影像学及实验室检查结果、诊治方法、治疗效果等。结果:两组患儿均有发热,但IKD组发热时间(10.2±6.6)d,长于CKD组的(6.8±2.8)d(P<0.05)。IKD组口唇皲裂、肢端硬肿或恢复期膜样脱皮、颈部淋巴结肿大、球结膜充血发生率均低于CKD组(P均<0.01)。IKD组的心脏血流异常、冠状动脉扩张、冠状动脉增厚、肺纹理增粗模糊、肺野斑点阴影发生率均高于CKD组(P均<0.05)。两组WBC、CRP、PLT、ESR、ALT、Hb等实验室检查指标比较差异无统计学意义(P>0.05)。结论:IKD的临床表现不典型,临床上应结合实验室和影像学检查结果,早诊断、早治疗,从而改善患儿症状,缩短治疗时间,提高治疗效果,减少冠脉损害等并发症的发生。

Objective： To analysis the clinical characteristics of complete Kawasaki disease（ CKD） and incomplete Kawasaki disease（ IKD）,explore the methods of diagnosis and treatment of incomplete Kawasaki disease. Methods： From January 2014 to March 2016,there were 67 cases of CKD（ CKD group） and 26 cases of IKD（ IKD group） selected as the research object,the clinical data including clinical manifestations, imaging and laboratory examination results, diagnosis and treatment, treatment effects of children were retrospectively analyzed. Results： The fever time of IKD group was（ 10. 2 ± 6. 6） d,which was significantly longer than CKD group（ 6. 8±2. 8） d（ P〈0. 05）. The incidence of fissured lips,acral scleredema or recovery period of membrane peeling,neck lymph nodes enlargement,conjunctival congestion in IKD group was lower than the CKD group（ P〈0. 05）. The incidences of abnormal cardiac blood flow,coronary artery dilation,coronary artery thickening,increase of lung markings,and the shadow of lung field spots in IKD group were higher than the CKD group（ P 0. 05）. There were no differences in most laboratory examination indexes（ WBC,CRP,PLT,ESR,ALT,Hb） between two groups. Conclusion： Clinical manifestations of incomplete Kawasaki disease is not typical,should be diagnosed with clinical laboratory and radiographic findings. Early diagnosis and treatment can improve children＇s symptoms,shorten the treatment time,improve the treatment effect,reduce the occurrence of complications such as coronary artery damage.