不完全川崎病的早期诊断  

The early diagnosis of incomplete Kawasaki disease

作　　者：刘丽辉[1] 肖超跃[1] 王波[1] 陈娟娟[1] 

机构地区：[1]广东省深圳市第二人民医院儿科,广东深圳518035

出　　处：《吉林医学》2013年第20期3995-3996,共2页Jilin Medical Journal

摘　　要：目的:对不完全川崎病(KD)的临床特点、实验室指标及超声心动图的变化进行临床分析,提高对不完全KD的早期诊断。方法:对32例不完全KD的临床特点、实验室检查及超声心动图变化的特点进行临床分析。结果:32例不完全KD均有发热,伴有其他临床诊断标准5项中1项或者3项。口唇皲裂18例,球结膜充血18例,皮疹20例,颈淋巴结肿大16例,肛周皮肤发红脱屑17例,卡瘢红15例,手足硬肿18例。实验室指标中ESR、PLT和CRP增高居多,分别占62.5%和56.2%,WBC升高和HB降低均为50%。超声心动图示左右冠状动脉急性期扩张11例,心包积液3例。结论:不完全KD在小婴儿中常见,临床表现肛周及会阴部皮肤潮红、脱屑,卡瘢红有助于不完全KD的早期诊断;实验室检查ESR>40 mm/h及CRP≥30 mg/L应考虑不完全KD的诊断;超声心动图发现冠状动脉损害(CAL)可作为不完全KD的重要诊断依据之一。Objective for nearly 5 years in our hospital treated 32 cases of incomplete Kawasaki disease （ KD ） and the clinical features,laboratory indicators and ultrasound heartbeat graph change clinical analysis, to improve the early diagnosis of incomplete KD. Methods clinical characteristics,characteristics of 32 cases with incomplete KD laboratory examination and ultrasound heartbeat graph change clinical analysis. Results 32 cases of incomplete KD had fever, accompanied by other clinical diagnosis standard 5,1 or 3.18 cases of chapped lips, 18 cases of conjunctival congestion ,swelling rash in 20 cases, 16 cases of cervical lymph nodes, 17 cases of perianal skin redness, scaling, the red card in 15 cases, 18 cases of scleredema. Laboratory indexes of ESR, PLT and CRP increased most, accounting for 62.5% and 56.2% respectively,WBC increase and HB decrease was 50%. Ultrasonic heartbeat diagram of left and right coronary artery acute dilatation in 11 cases,3 cases of pericardial effusion. Conclusion the incomplete KD common in small infants, clinical manifestations of perianal and perineal skin flushing,desquamation, early diagnosis card scar red contributes to incomplete KD; laboratory examination of ESR 〉 40mm/h and CRP ≥30 mg/L should be considered in the diagnosis of incomplete KD; ultrasound heartbeat graph discovery of coronary artery lesions （ CAL ） can be used as one of the important diagnosis of incomplete KD.

关 键 词：不完全 川崎病 诊断 

分 类 号：R725.4[医药卫生—儿科]