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不完全川崎病53例临床分析 预览 被引量:12

Clinical analysis of 53 cases of children with incomplete kawasaki disease
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摘要 目的:总结不完全川崎病(Kawasaki disease KD)的临床特征以利于早期诊断,改善预后。方法:对南京市儿童医院2005年3月至2009年2月诊治的53例不完全KD患儿的病历资料进行回顾性分析,并与同期诊治的228例完全KD患儿比较。结果:不完全KD主要临床表现发生率与完全KD组比较差异无统计学意义,不完全KD组卡疤红斑发生率及肛周充血脱屑发生率显著增高,呼吸系统症状、消化系统症状、神经系统症状显著增多,差异有统计学意义。两组实验室指标中白细胞(WBC)、中性粒细胞百分比(N%)、血色素(Hb)、血小板(PLT)、血沉(ESR)、C反应蛋白(CRP)、谷丙转氨酶(ALT)、血清白蛋白(ALB)、乳酸脱氢酶(LDH)差异无统计学意义。不完全KD组二维超声提示冠脉受累率42.3%,完全KD组为22.8%,差异有统计学意义。结论:不完全KD较完全KD更易发生冠状动脉受损。不完全KD诊断中应注意临床表现以外的症状体征,其中卡疤红斑及肛周充血脱屑可作为不完全川崎病诊断的辅助依据,结合实验室检查异常及心脏彩超对冠状动脉病变的检出可作出及时诊断。 Objective:To summarize clinical features of incomplete kawasaki disease(KD) for early diagnosis and improvement prognosis.Methods:The data of 53 cases with incomplete KD hospitalized in Nanjing Children's Hospital from March 2005 to February 2009 were retrospectively analyzed and were compare with 228 cases with complete KD in the same period.Results:There was no significant difference in the incidence of main clinical features between incomplete KD and complete KD.There was significant difference in the incidence of BCG vaccination red reaction,reddish anus and desquamation,respiratory system symptoms,digestive system symptoms,nervous system symptoms.No significant differences of WBC,N%,HB,PLT,ESR,CRP,ALT,ALB,LDH were found in the incomplete KD and complete KD.There was significant difference in the incidence of coronary artery lesions between incomplete KD(42.3%) and complete KD(22.8%).Conclusion:The incidence of coronary artery lesions was higher in incomplete KD than that in complete KD.The symptoms and physical signs not included in clinical diagnostic criteria,especially BCG vaccination red reaction and reddish anus and desquamation,should be paid attention in the diagnosis and synthetically analysed with echocardiography and abnormality in laboratory examination,which can be helpful to the timely diagnosis of incomplete KD.
作者 张雅媛 钱小青 李娟 俞海国 郭翼红 马慧慧 ZHANG Ya-Yuan,QIAN Xiao-Qing,LI Juan,YU Hai-Guo,GUO Ji-Hong,MA Hui-Hui.Nanjing Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China
出处 《中国免疫学杂志》 CAS CSCD 北大核心 2011年第11期 1035-1037,共3页 Chinese Journal of Immunology
关键词 川崎病 不完全川崎病 冠脉损害 早期诊断 Kawasaki disease Incomplete Kawasaki disease Coronary artery lesions Early diagnosis
作者简介 张雅媛(1970年-),女,硕士,副主任医师,主要从事小儿免疫性疾病研究,E-mail:zhangyayuan1207@126.com。
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