儿童川崎病369例的临床病例分析

Clinical analysis of 369 cases of Kawasaki's disease in children

目的:总结川崎病的临床特征,以指导临床诊断和治疗。方法:收治川崎病患儿369例,回顾性分析其临床资料。结果:川崎病患儿男女比例1.4∶1,年龄2个月25 d^13岁10个月,其中88.6%患儿年龄<5岁(327例),临床症状最常见的是发热,其他症状出现的频率依次为口唇充血皲裂336例(91.1%)、颈部淋巴结肿大309例(83.7%)、眼球结膜充血299例(81.1%)、皮疹255例(69.1%)、手足硬肿及蜕皮231例(62.6%)。92.7%KD患儿伴1种或1种以上其他系统脏器损害。冠状动脉扩张57例(15.4%),8.4%对静脉注射用人免疫球蛋白(IVIG)治疗无反应。结论:川崎病的发病有逐年增多趋势,及时诊断和治疗,坚持随访,注意心脏超声、血沉(ESR)、C反应蛋白(CRP)等的监测,可提高治疗效果,改善预后。

Objective:To summarize the clinical features of Kawasaki's disease,in order to guide the clinical diagnosis andtreatment.Methods:369 cases of children with Kawasaki disease were selected,and the clinical data were retrospectively analyzed.Results:The proportion of male and female patients with Kawasaki's disease was 1.4∶1.The age was from 2 months 25 days to 13years 10 months.Among them,88.6% of the children were less than 5 years old(327 cases).The most common clinical symptom wasfever.The frequency of other symptoms in turn were 336 cases(91.1% ) of congestion and chapped lips,cervical lymph nodeenlargement in 309 cases(83.7% ),ocular conjunctival hyperemia in 299 cases(81.1% ),rash in 255 cases(69.1% ),hand and footscleredema and molting in 231 cases(62.6% ).92.7% of KD children had one or more than one other system organ damage.57patients(15.4% ) had coronary artery dilatation;8.4% was no response to the human immunoglobulin for intravenousinjection(IVIG) treatment.Conclusion:The incidence of Kawasaki disease was increasing year by year.Timely diagnosis andtreatment,followed up and paying attention to the monitoring of cardiac ultrasound,erythrocyte sedimentation rate(ESR) andC-reactive protein(CRP) can improve the therapeutic effect and improve the prognosis.