儿童川崎病85例临床分析  

Clinical Analysis of 85 Cases of Kawasaki Disease in Children

作　　者：刘晓依[1] 何欢[1] 陈戟[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心皮肤科,上海200127

出　　处：《中国皮肤性病学杂志》2015年第11期1139-1141,共3页The Chinese Journal of Dermatovenereology

摘　　要：目的总结川崎病（KD）的临床特征，为临床医生早诊断和早治疗提供参考依据。方法回顾性分析2013年1月-12月上海市儿童医学中心诊治的85例KD住院患儿的临床资料，分析其临床特征。结果患儿年龄2个月-7岁，男：女为1．74：1。主要临床表现发生率依次为发热100％、结膜充血90．59％、口唇黏膜改变84．71％、皮疹81．18％、淋巴结肿大69．41％和四肢末端改变55．29％。实验室检查中WBC，PLT，CRP和ESR升高的发生率分别为38．82％，43．53％，90．59％和85．88％。〈2岁组较2～7岁组的KD患儿PLT升高发生率高。冠状动脉扩张发生率20．00％，发热率100．00％，以发热〉10d的KD患儿冠脉扩张发生率较高。有84例予静脉用丙种球蛋白（IVIG）＋阿司匹林治疗，有效80例，5例无效。结论KD患儿结膜充血、口唇黏膜改变和皮疹是仅次于发热的临床特征性表现，其对本病诊断价值较大，值得皮肤科医生注意，且尽早使用丙种球蛋白和阿司匹林对预防冠状动脉病变十分重要。Objective Summarize clinical feature of Kawasaki disease （KD） in order to diagnose and treat as early as possible. Methods Retrospect 85 cases of Kawasaki disease from Jan. to Dec. 2013 in Shanghai Children＇s Medical Center and summarize and analyse the clinical features. Results Age varied from 2 months to 7 years. The male to female ratio was 1.74：1. The incidence rate of clinical features were fever 100%, conjunc- tival congestion 90. 59% , changes of lips and oral cavity 84. 71% , polymorphous exanthema 81.18% , lymphadenopathy 69.41% and changes of peripheral extremities 55.29%, respectively. The incidence rates of white blood cell （ WBC ） increase, platelet counts （PLT） increase, C-reactive protein （CRP） increase and erythrocyte sedimentation rate （ESR） increase were 38.82%, 43.53%, 90. 59% and 85.88%, respectively. The incidence rate of PLT increase of children under the age of 2 years was higher than that of children ranged from 2 to 7 years. Coronary artery dilation accounted for 20. 00%. The rate of coronary artery dilation was higher in KD children with fever over 10 days. 84 cases of KD children were treated by intravenous immunoglobulin（IVIG） and aspirin therapy. And 80 cases of patients were treated effectively, and 5 cases failed to respond to initial therapy. Conclusion In addition to fever, conjunctival congestion, lips and oral cavity changes, rash were important clinical manifestations, which were helpful to the diagnosis of KD. Dermatologists can observe the clinical manifestations and make an early diagnosis of KD, and treatment with intravenous immunoglobulin and aspirin as early as possible which has important significance for preven- tion of coronary artery dilation.

关 键 词：川崎病 临床分析 实验室检查 冠状动脉扩张 

分 类 号：R725.4[医药卫生—儿科]