6个月内川崎病患儿临床特点

目的 分析6个月内川崎病(KD)患儿的临床特点,提高对该年龄组KD患儿的认识和早期诊断水平.方法 收集2005年1月-2010年12月本院收治的KD患儿487例,分为≤6个月组67例(14%),>6个月组420例(86%).≤6个月又分为冠状动脉病变组(CAL组)和冠状动脉正常组(NCAL 组),对患儿相关临床资料进行回顾性分析.结果≤6个月组和>6个月组临床表现(球结膜充血:68.7% vs 79.5%,P<0.05;颈部淋巴结大:25.4% vs 64.3%,P<0.05)及实验室检查白细胞计数(20.31±0.83)×109 L-1 vs (16.56±0.29)×109 L-1,P <0.05;血红蛋白 (97.37±1.22) g·L-1 vs (109.01±0.64) g·L-1,P<0.05;血小板(453.34±22.99 )×109 L-1 vs (338.26±6.33)×109 L-1,P<0.05;AST (43.87±6.52) U ·L-1 vs (67.64±4.23) U·L-1,P<0.05]均存在显著差异.虽然≤6个月组不完全KD的发病率明显升高(59.7% vs 33.6%,P<0.05),但冠脉损害率无显著差异(52% vs 53%,P>0.05).≤6个月CAL组和NCAL 组血红蛋白及血小板比较,差异均有统计学意义.结论 6个月内小婴儿由于临床表现迟发,且不典型,诊断及治疗也就相应延迟,心脏超声示冠状动脉异常可作为6个月内完全KD确诊的金指标.

Clinical Characteristics of Kawasaki Disease in Infants Younger than 6 Months

Objective To investigate the clinical and laboratory characteristics of Kawasaki disease(KD) in infants younger than 6 months,in order to diagnose early.Methods From Jan.2005 to Dec.2010,487 patients with KD in Yuying Children′s Hospital of Wenzhou Medical College were included.Group 1 consisted of 67(14%) patients younger than 6 months,and group 2 consisted of 420(86%) patients older than 6 months;and group 1 was again divided into 2 groups:coronary artery lesion(CAL) group and non coronary artery lesion(NCAL) group.Clinical manifestations,laboratory results,echocardiographic findings were compared between those groups.Results Clinical manifestations(conjunctival injection:68.7% vs 79.5%,P<0.05;lymphadenopathy:25.4% vs 64.3%,P<0.05) and laboratory resultswhite blood cellcount(20.31±0.83)×109 L-1 vs(16.56±0.29)×109 L-1,P<0.05;hemoglobin(97.37±1.22) g·L-1 vs(109.01±0.64) g·L-1,P<0.05;platelet(453.34±22.99)×109 L-1 vs(338.26±6.33)×109 L-1,P<0.05;aspartate transaminase(43.87±6.52) U·L-1 vs(67.64±4.23) U·L-1,P<0.05].Younger infants were more likely to have incomplete presentation(59.7% vs 33.6%,P<0.05).The laboratory results of hemoglobin and platelet were different between CAL group and NCAL group,there were significant diffe-rence(Pa<0.05).Conclusions Early diagnosis and timely treatment are difficult in younger infants younger than 6 months with KD because of delayed and incomplete clinical presentations,echocardiogram becomes an important implement for diagnosis.