川崎病并多器官损害202例  

Multiple Organic Damages in 202 Cases with Kawasaki Disease

作　　者：张宝红[1] 陈晓波[1] 杜军保[2] 

机构地区：[1]首都儿科研究所附属儿童医院内分泌科,北京100020 [2]北京大学第一医院儿科,北京100034

出　　处：《实用儿科临床杂志》2009年第1期31-32,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的分析川崎病器官损害的临床表现,提高KD的诊断水平。方法2000年1月-2007年10月首都儿科研究所附属儿童医院住院的202例KD患儿,行血、尿、粪常规、肝肾功能、胸部X线片、心电图、超声心动图、脑电图、脑脊液、肠道、呼吸道病毒等检测,并进行临床资料分析,总结KD器官损害的发生率。结果202例患儿中男137例,女65例;男女比例为2.11.0;年龄分布以婴幼儿为主,3岁以内(包括3岁)占71.3%。各器官受累情况:血液系统受累78例,占38.6%;呼吸系统受累76例,占37.6%;心血管系统受累68例,占33.7%;泌尿系统受累52例,占25.6%;消化系统受累23例,占11.4%;中枢神经系统受累3例,占1.5%;并败血症3例,幼年型类风湿关节炎、过敏性紫癜各1例。结论KD可累及全身多个器官,以血液系统受累率最高,并可同时并多个器官受累。KD临床表现多样,症状出现时间不一。临床医师不仅要掌握其典型的临床表现,对少见临床表现及器官损害也要有全面的认识。Objective To analyze the clinical features of organic damages in Kawasaki disease （KD）, and to improve the diagnosis and treatment level. Methods Two hundred and two cases with KD admitted in Children＇s Hospital Affiliated to Capital Institute of Pediatrics from Jan. 2000 to Oct. 2007 were reviewed,and their blood routine,urine,stool routine,liver function, kidney function, chest X - ray, and so on, were investigated. The incidence of organic damages in KD was evaluated. Results Among the 202 KD children, 137 were male and 65 were female,the male - female ratio was 2.1 ： 1.0. Most of them were infants,and 71.3% of them were younger than 3 years old. The dama- ges of hematological system were detected in 78/202 cases （38.6%） ,respiratory system 76/202 cases （37.6%） ,cardiovascalar system 68/ 202 cases （33.7%） ,urinary system 52/202 cases （25.6%） ,digestive system 23/202 cases （ 11.4% ） , and central nervous system 3/202 cases （1.5%）. On the other hand,3 cases complicated with septemia, 1 case with juvenile rheumatoid arthritis and 1 case with Henoch - Sehonlein purpura. Conclusions The data indicate that the incidence of hematological system involvement in the sick - children with KD were highest,with more than 2 organs involved simahaneously. Many organic damages were involved in KD and diverse clinical manifestation could be found. Physicians should understand not only the typical features but also the rare symptoms and organic damage so as to prevent mis- diagnosis and improper treatment.

关 键 词：皮肤黏膜淋巴结综合征 器官损害 儿童 

分 类 号：R725.4[医药卫生—儿科]