首诊误诊为淋巴结炎的不完全川崎病临床表现分析

Analysis of Clinical Manifestations of Incomplete Kawasaki Disease with Lymphadenitis

目的:分析首诊误诊为淋巴结炎的不完全川崎病的临床表现特征,为不完全川崎病的临床诊治提供可靠信息。方法:选取2015年1月-2017年1月笔者所在医院确诊的56例典型川崎病患儿(对照组),抽取同期首诊误诊为淋巴结炎的27例不完全川崎病患儿(观察组),观察临床表现,对比两组患儿在临床表现上存在的差异。结果:两组患儿均有发热,观察组发热持续时间较对照组长,差异有统计学意义(P<0.05);观察组淋巴结肿大出现率,显著高于对照组,差异有统计学意义(P<0.05);口唇症状、结膜充血、皮疹、指/趾端改变出现率,显著低于对照组,差异有统计学意义(P<0.05);观察组心血管相关并发症发生率为14.81%,高于对照组患儿的1.79%,差异有统计学意义(P<0.05)。结论:首诊误诊为淋巴结炎的不完全川崎病患儿与典型川崎病患儿的临床表现存在一些明显的差异,前者的发热持续时间更长,与心血管相关的并发症发生率更高。临床医师应加强对不完全川崎病临床表现的鉴别,以减少该疾病的漏诊和误诊。

Objective：To analyze the clinical manifestations of incomplete Kawasaki disease misdiagnosed as lymphadenitis in the first consultation,and to provide reliable information for clinical diagnosis and treatment of incomplete Kawasaki disease.Method：The children diagnosed as typical Kawasaki disease（the control group） from January 2015 to January 2017 in our hospital were selected and the incomplete Kawasaki disease children（the observation group） misdiagnosed lymphadenitis during the same time as the first visit were selected.the clinical manifestations were observed,and the two groups of children in the clinical manifestations of the differences were compared.Result：Both groups of children had fever,and the duration of fever in the observation group was longer than the control group（P〈0.05）.The incidence of lymphadenopathy in the observation group was significantly higher than the control group（P〈0.05）,and the incidence of lip symptoms,conjunctival hyperemia,rash,and finger/toe changes was significantly lower than the control group（P〈0.05）.The incidence of cardiovascular-related complications in the observation group was 14.81%,was higher than the control group 1.79%（P〈0.05）.Conclusion：There are some obvious differences in the clinical manifestations on the first diagnosis was misdiagnosed as an incomplete Kawasaki disease of lymphadenitis and typical Kawasaki disease children.The former has a longer duration of fever and a higher incidence of cardiovascular-related complications.Clinicians shall strengthen the identification of clinical manifestations of incomplete Kawasaki disease in order to reduce the missed diagnosis and misdiagnosis of the disease.