川崎病患儿多器官损害及其冠状动脉瘤的发生  

Clinical Study of the Multi-organ Lesions and the Occurrence of Coronary Aneurysms of 92 Pediatric Inpatients with KD.

作　　者：郑代明[1] 孟晓慧[1] 高志伟[1] 王建羡[1] 汪翼[1] 马沛然[1] 

机构地区：[1]浙江省丽水市人民医院儿科,323000

出　　处：《医学研究杂志》2008年第1期84-86,共3页Journal of Medical Research

摘　　要：目的探讨川崎病(Kawasaki disease,KD)多器官损害和各脏器受累时冠状动脉瘤(coronary aneurysms,CAA)发生的情况。方法对1997年6月至2006年12月住院的92例KD患儿,进行3大常规、肝功能、心肌酶谱、心电图、X线胸片及超声心动图(UCG)等检测,结合临床表现确定受累器官及CAA的发生。结果92例KD患儿各器官受累情况:心脏66例(71.7%)、肺脏34例(37.0%)、肝脏32例(34.8%)、肾脏17例(18.5%)、胃肠道14例(15.2%)、脑11例(12.0%)、关节9例(9.8%)、脾脏2例(2.2%)、胆囊1例(1.1%);CAA18例(19.6%),其中巨大CAA3例(3.3%)。同时两个器官受累率为40.2%(37/92)、3个器官受累率为26.1%(24/92)、4个及以上器官受累率为8.7%(8/92)。CAA在各器官受累时的发生率:脑45.5%(5/11)、关节44.4%(4/9)、心包积液41.7%(5/12)、肺脏23.5%(8/34)、肝脏18.8%(6/32)、肾脏17.6%(3/17)、胃肠道14.3(2/14)。结论KD时,各器官均可受累,心脏受累率最高,其他依次为肺、肝、肾、胃肠道、脑、关节等,并可同时并发多个器官受累,2个及2个以上器官同时受累率为75.0%。CAA在各器官受累时的发生率不同,本组资料显示KD合并脑、关节病变及心包积液时CAA的发生率明显升高。Objective To investigate the multi - organ lesions and the occurrence of coronary aneurysms in children with Kawasaki disease （KD）. Methods 92 pediatric inpatients with KD were enrolled and studied. The organs involved and coronary aneurysms （CAA） were determined by checking blood routine, urine routine, stool routine, chest X - ray, electrokardiogram,liver function, echocardiogram, and clinical manifestation. Results The incidence of various organs involved in 92 patients with KD： heart 71. 7% ; lung 37.0% ; liver 34.8% ;brain 12.0% ;kidney 18.5% ;gastrointestinal tract 15.2% ;spleen 2.2% ;gallbladder 1.1% ;joints 9.8%. In addition, the rate of two organs involved simultaneously was 40.2% , three and more 34.8%. The incidence of CAA in brain lesion, joints lesion and pericardial effusion complications of KD was 45.5% , 44.4% , and 41.7% , respectively. Conclusions The data shows that the incidence of heart involvement in the sick - children with KD is highest, and other organs, such as lung, liver, kidney, gastrointestinal tract, brain and joints are involved in turn. The incidence of 2 and more organs involved simultaneously amounts to75.0%. CAA is the most serious complication of KD. Our study suggests that the incidence of CAA is obviously high in these lesions of brain,joints and pericardial effusion involvement in KD.

关 键 词：川崎病 多器官损害 冠状动脉瘤 

分 类 号：R722.12[医药卫生—儿科] R725.97[医药卫生—临床医学]