不典型川崎病55例临床及实验室特征分析
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Clinical Analysis and Laboratorial Character of 55 Cases of Atypical Kawasaki Disease
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    摘要:

    目的探讨不典型川崎病的临床特征、实验室检查、冠状动脉损害的危险因素及治疗方法。方法对55例不典型川崎病患儿资料进行了回顾性分析和总结。结果本组患儿有早期诊断意义的临床表现有持续高热(100%),球结膜充血(54.5%),唇及口腔表现(72.7%),手足指趾硬肿(63.6%),皮疹(29.1%),颈淋巴结肿大(30.9%)。另外肛周潮红或伴脱皮(58.2%),卡疤红肿(52.7%)也有早期诊断参考价值。实验室检查中红细胞沉降率明显增快(69.1%),C反应蛋白显著增高(56.4%),血小板计数显著增高(49.1%)或白细胞计数升高(60.0%)等结果对判断是否为不典型川崎病更有协助诊断的价值,同时尽早行心脏彩色B超检查,合并冠状动脉损害者12例,其中冠状动脉扩张11例,冠状动脉瘤1例。对合并冠状动脉损害者随访6个月至18个月,完全恢复正常者12例。结论提高对不典型川崎病的认识,及时完善相关检查,尽早明确诊断,合理治疗,减少冠状动脉的损伤。

    Abstract:

    Aim To investigate the clinical features,laboratory examination,risk factors of coronary artery lesions and treatment for atypical kawasaki disease. Methods A total of 55 patients with atypical kawasaki disease were reviewed. Results In this group of cases,persistent fever(100%),bulbar conjunctiva congestion(54.5%),the change of lip and mouth(72.7%)、the end of hand and foot being hard and swollen (63.6%),Skin rash(29.1%)and the limphs in neck swelling(30.9%) had significance in early diagnosis of atypical kawasaki disease (KD),in addition,flush or exuviation around the anus (58.2%) and BCG vaccination scar being red and swollen (52.7%) also had reference significance. In laboratory target,erythrocyte sedimentation rate markedly increased(69.1%),C response protein obviously went up(56.4%) and platelets remarkably increased (49.1%) or white blood cells evidently increased(60%),so these could give assistance in the diagnosis of atypical kawasaki disease (KD). At the same time,it should be as early as possible to apply echocardio graphy. 12 cases were complicated with coronary artery lesions,including 11 coronary artery dilations,1 coronary artery aneurysms. The patients with coronary artery lesions were followed up from 6 months to 18 months,and 12 cases regressed completely. Conclusion It is necessery to enhance the vigilance of atypical kawasaki disease,consummate the correlation inspection promptly,make clear about the diagnosis and the treatment as soon as possible to reduce the coronary artery damage.

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罗永姣,蔡泽民,刘红英.不典型川崎病55例临床及实验室特征分析[J].中国动脉硬化杂志,2009,17(7):555~557.

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  • 收稿日期:2009-05-10
  • 最后修改日期:2009-06-18
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