川崎病患者早期识别与诊断的临床分析

目的探讨川崎病（KD）患儿的早期临床诊断方法，提高早期确诊率。方法选取我院2008年5月～2012年3月期间收治的93例川崎病患儿为研究对象，按照分级标准分为典型KD组和非典型KD组，比较两组患儿的临床表现特征、实验室检查及冠状动脉损害情况，探讨早期诊断KD的方法。结果两组患儿均有不同程度发热表现，典型组患儿其他临床表现除肛周脱皮外发生率均高于非典型组，非典型组患儿肛周脱皮发生率明显高于典型组。两组患儿白细胞数值比较无明显差异，血红蛋白、血沉、血小板、心肌酶CK—MB及白蛋白比较均有显著差异，具有统计学意义（P〈0．05）。典型组患儿冠脉损害发生率为3．85％，非典型组患儿冠脉损害发生率为73.3％。两组患儿冠脉损害发生率比较差异有统计学意义（X2=19．436，P〈0．05）。结论KD临床以典型患儿为主，肛周脱皮、冠脉损害多见于非典型患儿，可据此对KD患儿进行早期识别与诊断，对提高后期治疗效果具有重要意义。

Clinical analysis of early recognition and diagnosis for kawasaki disease patients

Objective To investigate the early clinical diagnosis method of kawasaki disease （ KD ） children, improve the rate of early diagnosis. Methods In our hospital from May 2008 to March 2012, 93 cases of children with kawasaki disease were selected as the research object, according to the grading standards they were divided into typical and atypical KD group, the clinical features, laboratory examination and coronary artery injury were compared, early diag- nosis of KD method was investigated. Results The two groups had different degrees of fever, the typical group with other clinical manifestations in addition to perianal peeling occurs outside, the rates were higher than those of atypical groflp, perianal skin incidence of atypical cases was significantly higher than typical group. Two groups of numerical comparison of white blood cells had no obvious difference, hemoglobin, platclet, erythrocyte sedimentation rate, myo- cardial enzyme CK-MB and albumin were significantly differences （P 〈 0.05）, with statistical significance. Coronary artery lesion rate of typical cases and atypical group were 3.85%, 73.3%, had significant difference （X2=19.436, P 〈 0.05）. Con- clusion KD clinical is priority to typical children, perianal skin peeling, coronary artery lesions is priority to atypical children, based on this KD children can be early recognized and diagnosed, has important significance to later treat- ment effect.