63例儿童川崎病的临床分析

目的了解儿童川崎病(kawasaki disease,KD)的临床特点,诊断治疗及冠脉损伤危险因素,为临床诊治提供参考。方法选取2014年7月至2019年7月63例确诊为川崎病的患儿临床资料进行回顾性分析,统计比较不同类型川崎病患儿的性别、年龄、主要临床症状、相关实验室检查、心脏彩超、合并症和治疗效果。结果 63例KD患儿中,典型KD 41例,不完全KD 22例,合并冠状动脉损害(coronary artery disease,CAL)19例,其中典型KD为34.15%(14/41),不完全KD为22.73%(5/22),两组患者CAL发生率差异无统计学意义;典型KD的球结膜充血、淋巴结肿大、多形性皮疹、手足硬肿显著高于不完全KD,差异有统计学意义(P<0.05)。两组患儿WBC、中性比例、HGB、PLT、CRP、ESR比较差异无统计学意义。结论不完全KD临床表现不典型,易误诊、漏诊,结合实验室指标,对该病早诊断、早治疗,可减少儿童冠状动脉损害发生率。

Clinical analysis of 63 children with Kawasaki disease

Objective To understand the clinical characteristics of Kawasaki disease(KD)in children,diagnosis and treatment and risk factors of coronary artery injury,provide reference for clinical diagnosis and treatment.Methods Retrospective analysis was conducted on the clinical data of children diagnosed with Kawasaki disease from July 2014 to July 2019 to statistically compare the gender,age,main clinical symptoms,relevant laboratory tests,cardiac color ultrasound,complications and therapeutic effects of children with different types of Kawasaki disease were satistically compared.Results Among 63 children with KD,41 cases were typical KD,22 cases were incomplete KD,19 cases were complicated with coronary artery disease(CAL),among which typical KD was 34.15%(14/41)and incomplete KD was 22.73%(5/22),there was no significant difference in the incidence of CAL between the two groups.Conjunctical congestion,lymph node enlargement,pleomorphic rash and hand and foot scleroma of typical KD were significantly higher than incomplete KD,with statistically significant difference(P<0.05).There was no significant difference in WBC,neutral ratio,HGB,PLT,CRP and ESR between the two groups.Conclusion Incomplete KD is easy to be misdiagnosed and missed diagnosis because of its atypical clinical manifestations.Combined with laboratory indicators,early diagnosis and treatment of KD can reduce the incidence of coronary artery damage in children.