3月龄内川崎病患儿临床特点及中期随访

Clinical characteristics and mid-term follow-up of Kawasaki disease in infants under 3 months

目的总结3月龄内川崎病(KD)患儿的临床特点、随访及预后。方法回顾分析2009年1月至2013年12月期间确诊KD的3月龄以下患儿临床资料。结果同期确诊KD患儿共1 504例,其中3月龄内婴儿为40例,占2.66%;男30例、女10例。除发热外,其他5项主要临床表现的出现频率均低于50%。实验室检查提示炎性反应、血小板增多、贫血等。32例(80%)有冠状动脉病变,其中冠状动脉扩张24例、冠状动脉瘤8例,冠状动脉巨大瘤为3例。截止随访日期,所有患儿均无心肌缺血、心肌梗死、死亡等,37例(92.5%)冠状动脉内径正常,3例巨大冠状动脉瘤患儿仍为冠状动脉瘤并血栓形成。结论小婴儿KD临床表现不典型,冠状动脉病变发生率高,应及时行彩色多普勒超声心动图。

Objective To summarize the clinical characteristics,follow-up and prognosis of Kawasaki disease(KD) in infants under 3 months.Method The clinical data of infants under 3 months diagnosed with KD during January 2009 to December 2013 were analyzed retrospectively.Results In a total of 1504 cases diagnosed with KD during during the study period,there were 40(2.66%) infants under 3 months(30 males and 10 females).Except for fever,the frequencies of the other 5 main clinical manifestations were less than 50%.Laboratory tests suggested inflammatory reactions,thrombocytosis,anemia,and so on.Coronary artery disease was found in 32 cases(80%),including 24 cases of coronary artery dilatation,8 cases of coronary artery aneurysm and 3 cases of coronary giant aneurysm.By the end of the follow-up period,there were no myocardial ischemia,myocardial infarction and death in all the patients;coronary artery diameter was normal in 37 cases(92.5%);3 cases of giant coronary artery aneurysm still had coronary artery aneurysm and thrombosis.Conclusion The clinical manifestations of KD in little infants were atypical,the incidence of coronary artery disease is high,and color doppler echocardiography should be performed in time.