821例小儿风湿病住院患儿分析

为探讨武汉市近年来小儿风湿病住院患儿的临床特点，回顾分析了武汉市儿童医院1997年1月1日至2001年12月31日期间821例小儿风湿病住院患儿的病史资料。结果显示，小儿风湿病主要由过敏性紫癜(HSP)、川崎病(KD)、幼年型类风湿性关节炎(JRA)、风湿热(RF)构成，KD已取代JRA、RF，其构成比(30．0％)仅次于HSP(59．1％)。小儿风湿病常引起心血管、脑等多器官系统损害，本组病例中，KD冠状动脉病变发生率为37．4％，其中冠状动脉瘤发生比为4．5％；36例HSP患儿进行了脑电图检查，其中轻一中度异常9例oKD血沉平均为86．3mm／h，故血沉明显增快是有助于KD早期诊断的一个强指标。风湿病有复发倾向，JRA、HSP复发率较高，RF、KD复发率低。

Analysis on 821 children with rheumatic disorders

To explore the clinical characteristics of childhood rheumatic disorders in recent years in Wuhan, we retrospectively analyzed the clinical data of 821 cases admitted to Wuhan Children's Hospital from January 1, 1997 to December 31, 2001. The results showed that childhood rheumatic disorders were mainly composed of Henoch-Schonlein purpura (HSP),Kawasaki disease(KD), juvenile rheumatoid arthritis(JRA)and rheumatic fever(RF) .KD has already replaced the position of JRA and RF, the constituent proportion of KD was 30.0%, second to HSP(59.1%), followed by JRA (6.2%)and RF(3. 5%) .Childhood rheumatic disorders often affect multiple organs and systems such as cardiovascular system , central nervous system, etc. The incidence of coronary arterial lesion of KD was 37.4% , while the incidence of coronary aneurysm was only 4. 5%, significantly lower than that reported by foreign groups, which may relate to the wide application of gamma immunoglobulin of the early cardio-echography examination before the formation of aneurysms or due to misdiagnosis. Therefore, children with KD should be followed up periodically with cardio-echography or coronary artery imaging. Electroencephalogram was carried out in 36 cases with HSP, with 9 cases having mild or moderate abnormal finding. The erythrocyte sedimentation rate (ESR)was increased in all 4 common rheumatic diseases. The mean level of ESR in KD patients was 86.3 mm/h and happened in early stage of disease, therefore it could be served as a powerful indicator in the early diagnosis of KD. Childhood rheumatic disorders have the tendency of recurrence , the recurrence rate of JRA(23. 5% )and HSP (13.8%) was higher than those of RF(6.9%) and KD(1.6%) . In our patients it has close relationship to the fast reduction of the immunosuppresive drug dosage, such as corticosteroid.etc.