10例以非感染性腹泻起病的不完全川崎病报道

目的:探讨临床上以非感染性腹泻起病的不完全川崎病(IKD)的临床特点及诊断依据，以早期发现并诊治，减少心血管系统并发症及改善预后。方法:回顾性分析2016年12月至2020年6月我院儿科10例以非感染性腹泻起病的IKD患儿的临床资料及实验室检查结果。结果:以非感染性腹泻起病的IKD主要临床表现为无明显诱因出现反复腹泻、发热，渐出现结膜充血、口唇皲裂、浮肿、贫血、肛周脱皮；实验室检查中，C反应蛋白、降钙素原、血清淀粉样蛋白、血沉、血小板水平明显增高；持续监测心脏彩超可见冠状动脉病变。结论:以非感染性腹泻起病的IKD早期临床表现以反复腹泻、发热为主，大便培养、血培养无阳性发现，实验室检查炎症指标明显增高，但住院治疗过程中抗感染疗效欠佳，此时均应尽早行心脏彩超检查，尽早明确IKD临床诊断，及早治疗，减少冠脉病变发生。

Report of 10 Cases of Incomplete Kawasaki Disease with Non-Infectious Diarrhea Onset

Objective: To probe into the clinical features and diagnostic basis of incomplete Kawasaki disease (IKD) with non-infectious diarrhea onset, and to provided early detection and treatment, reduce the cardiovascular system complications and improve the prognosis. Methods: Clinical data and laboratory results of 10 IKD children with non-infectious diarrhea onset in pediatrics of our hospital from Dec. 2016 to Jun. 2020 were retrospectively analyzed. Results: The main clinical manifestations of IKD with non-infectious diarrhea onset were repeated diarrhea, fever, conjunctival congestion, chapped lips, edema, anemia and perianal peeling. Laboratory examinations showed C-reactive protein, procalcitonin, serum amyloid protein, erythrocyte sedimentation rate and platelet increased significantly, and coronary artery disease could be seen by continuous monitoring of cardiac color Doppler echocardiography. Conclusion: The early clinical manifestations of IKD with non-infectious diarrhea onset are mainly repeated diarrhea and fever, with no positive results in stool and blood culture. Laboratory examinations shows that the inflammatory factors increase significantly. During hospitalization, the effect of anti-infection is not satisfied, color Doppler echocardiography should be performed as early as possible, clinical diagnosis of IKD should be confirmed as soon as possible, and early treatment should be carried out to reduce the occurrence of coronary artery disease.