547例川崎病临床分析及伴冠脉病变高危因素探讨

目的 总结川崎病(Kawasaki disease,KD)的临床特征,探讨KD临床表现与预后的关系,了解KD并发冠状动脉病变(coronary artery lesion,CAL)的危险因素.方法 同顾性分析1990年1月至2006年10月间547例住院KD患儿的临床资料,比较典型与不典型KD的临床特征,并探讨KD并发冠状动脉病变的高危因素.结果 547例中典型KD 434例,不典型KD 113例,不典型KD CAL发生牢较高(P＜0.05);除肛周脱屑外,其他临床症状发生少,出现晚(P＜0.05).547例KD中并发CAL 103例(18.82%),相关因素分析显示发病年龄、性别、血沉、血小板、C-反应蛋白与CAL发生率有密切关系.结论 不典型KD的CAL发生率较高,肛周脱屑较其他临床症状出现早,可以作为早期诊断线索之一;3岁以下的男孩及血沉、血小板、C-反应蛋白明显升高是CAL的高危因素.

547 cases of Kawasaki disease and related risk factors of coronary artery lesion

Objectives Clinical characteristics and treatment of Kawasaki disease(KD)and its risk factors related to coronary artery lesion(CAL)were investigated. Methods Clinical features,diagnosis and treatment for a total of 547 patients hospitalized with KD during January 1990 to October 2006 were reviewed. Clinical features of typical and incomplete KD were compared and the related risk factors of CAL were analyzed. Results Typical KD was diagnosed in 434 cases,and incomplete KD in 113 cases. There was higher prevalence of CAL among incomplete KD group compared with that in typical KD group(P < 0.05). With the exception of peri-anus desquamation,other clinical manifestations in incomplete KD were sporadic. Of the 547 cases,103(18.82 %)got CAL. The related risk factors of CAL include age,gender,level of platelet,C-reaction protein and erythrocyte sendimentation rate. Conclusions Incomplete KD had high prevalence of CAL. The perianus desquamation was an important clue for early diagnosis of incomplete KD. The high risk factors of CAL include male,younger than 3 years old,elevated erythrocyte sendimentation rate,C-reaction protein and increased blood platelet counts.