不典型川崎病42例临床分析

Clinical analysis of 42 cases of atypical Kawasaki disease

目的探讨不典型川崎病的早期临床表现特征、实验室检查结果及治疗方法。方法选择2013年5月至2015年7月湖南省儿童医院感染科收治的不典型川崎病42例和典型川崎病44例为研究对象。分析两组患儿的临床资料。结果典型川崎病患儿临床表现中确诊前发热时间、皮疹、口唇皲裂、手足硬肿的发生率均高于不典型川崎病患儿,差异有统计学意义(P<0.05)。两组患儿的各项实验室检查项目中,典型川崎病患儿心肌酶学值升高的发生率显著高于不典型川崎病患儿,冠状动脉出现改变在病程中出现的时间显著低于不典型川崎病患儿,差异有统计学意义(P<0.05)。两组患儿最终均完全康复,无明显后遗症,无死亡病例。结论不典型川崎病临床表现复杂多样,对川崎病进行诊断时,应结合临床表现与实验室指标及患儿影像学检查结果综合分析,尽可能的避免漏诊、误诊或延误诊断,尽早对患儿进行药物综合治疗。

ObjectiveTo investigate the early clinical manifestations,laboratory findings and treatment of atypical Kawasaki disease.MethodsForty two patients with a typical Kawasaki disease and44cases of typical Kawasaki disease were enrolled in this study,who were treated from May2013to July2015in Hunan Children's Hospital.The clinical data of the two groups were analyzed.ResultsThe incidence of fever time,rash,chapped lips and chiropractic in children with typical Kawasaki disease was significantly higher than that in children with atypical Kawasaki disease(P<0.05).The incidence of myocardial elevation was significantly higher in children with typical Kawasaki disease than that in children with atypical Kawasaki disease,and the duration of coronary artery changes in the disease course was significantly lower than that in children with atypical Kawasaki disease,the difference being statistically significant(P<0.05).Both of the two groups of children fully recovered,and there were no obvious sequelae or deaths.ConclusionThe clinical manifestations of atypical Kawasaki disease are complex and diverse.When the diagnosis of Kawasaki disease is carried out,clinical manifestations laboratory indicators,and children's imaging findings should be considered in the comprehensive analysis to avoid missed diagnosis,misdiagnosis or delayed diagnosis as much as possible,and comprehensive treatment with drugs should be performed as soon as possible.