川崎病272例分析

目的 探讨川崎病的临床特点。方法 回顾性分析2002—2006年272例川崎病患儿的临床、实验室及辅助检查资料。结果 272例川崎病患儿中男女之比为2.58 ∶ 1，发病年龄多为1 ~ 3岁，占59.2%。发热持续5 d以上者占100%，全身一过性多形皮疹的发生率为76.1%，两眼球结膜充血为74.6%，口唇潮红皲裂为47.8%，杨梅舌为58.5%，早期手足硬肿、掌跖泛红为22.8%，亚急性期甲床皮肤交界处膜样脱皮为31.2%，颈淋巴结肿大为36%。实验室检查白细胞增高者占80.5%，血小板增高者占87.5%，ESR增快者占96.2%，C反应蛋白阳性者占81.6%。心脏彩超显示合并不同程度的冠状动脉损害者占54.3%。272例患儿均采用阿司匹林治疗，258例患儿联合应用大剂量静脉注射人丙种球蛋白治疗。所有患儿均热退病情稳定后出院，平均住院8.9 d。结论 对出疹性疾病伴发热，尤其是发热时间超过5 d、抗生素治疗无效者应高度怀疑川崎病；血小板指标及心脏彩超对本病的诊断有帮助。阿司匹林是治疗本病的首选药物，同时联合应用大剂量静脉注射人丙种球蛋白可以短期内控制发热症状。

Clinical analysis of 272 patients with Kawasald disease

Objective To investigate the clinical features of Kawasaki disease.Methods A retrospective analysis was performed in 272 children diagnosed as Kawasaki disease from 2002 to 2006.Clinical data,laboratory findings and auxiliary examination results were collected for these patients.Results The male-to-female ratio Was 2.58:1.Onset ages between 1 to 3 years accounted for 59.2%of patients.Of these patients,100%had a fever for more than 5 days,76.1%transient polymorphous exanthema,74.6% bilateral conjunctival hyperemia,47.8%flare and fissure on the oral lip,58.5%strawberry tongue,22.8% firm swelling of hands and feet as well as flushing of palms and soles,3 1.2%subacute desquamation at the junctional site between nail bed and skin,36%cervical lymphadenopathy.Laboratory findings showed a significant increase in the count of peripheral blood leukocytes and pefipheral blood platelets as well as erythrocyte sedimentation rate in 80.5%,87.5%and 96.2% of Patients,respectively.Additionally,81.6%of these patients were positive for C reactive protein and the frequency of coronary aaery involvement was 54.3%.All patients were treated with aspirin,and high-dose intravenous immunoglobulin was given to 258 patients.Fever relieved and the condition was controlled in all patients with an average hospitalization period of 8.9 days.Conclusions Kawasaki disease should be suspected in Patients with exanthematous lesions,fever lasting for more than 5 days and poor response to antibiotic therapy.Peripheral blood platelet count and cardiac ultrasound are of great value in the diagnosis of Kawasaki disease.Aspirin iS the first choice in treating Kawasaki disease,and adjunctive high-dose intravennous immunoglobulin treatment may facilitate the quick control offever.