不典型川崎病的早期临床分析  

Early Clinical Analysis of Atypical Kawasaki Disease

作　　者：夏玉平[1] 

机构地区：[1]江苏省镇江市第一人民医院,212002

出　　处：《辽宁医学杂志》2016年第2期19-20,共2页Medical Journal of Liaoning

摘　　要：目的了解不典型川崎病(KD)的早期临床表现,提高不典型川崎病的早期诊断水平,降低儿童后天性心脏病的发病率。方法将本院2008年1月至2014年7月收治的79例川崎病进行回顾性临床分析,分别用A、B两种诊断标准(A为传统诊断标准、B为参考诊断标准)对其进行分析。结果实验室检查指标异常率依次为红细胞沉降率增快(91.14%)、C反应蛋白升高(88.61%)、血小板计数升高(87.34%)、白细胞总数升高(86.08%);传统诊断标准以外的常见的临床表现中,肛周红肿脱皮发生率为53.17%,卡介苗瘢痕红肿发生率为49.37%。B标准将红细胞沉降率增快、C反应蛋白升高、血小板计数升高、白细胞总数升高、肛周红肿脱皮、卡介苗瘢痕红肿纳入参考诊断标准,其在发病第6天诊断率与A标准比较由56.96%提高到77.22%(P<0.05)。结论结合红细胞沉降率增快、C反应蛋白升高、血小板计数升高、白细胞总数升高、肛周红肿脱皮、卡介苗瘢痕红肿,可提高对不典型川崎病的早期诊断率。Objective To get acquaintance with the early clinical manifestations of atypical Kawasaki Disease,improve the diagnosis rate of it at early phase,and reduce the incidence of acquired heart disease in children. Methods Using retrospective analysis on the 79 cases of Kawasaki Disease in our hospital during January 2008 and July 2014,find out valuable laboratory examinations and common clinical features outside of the traditional diagnositic criterion. Using two kinds of dignositic criteria named A,B（ A is the traditional dignositic criterion,B is the referential dignositic criterion） to analysis. Results Of the 79 cases,the abnormality rates of laboratory examinations are erythrocyte sedimentation rate increasing（ 91. 14%）,C react protein increasing（ 88. 61%）,platelet count increasing（ 87. 34%）,total number of white blood cells increasing（ 86. 08%）; Among the common clinical features outside of the traditional diagnosis standard,the incidence of crissum inflamed skin peeling is 53. 17%,BCG scar swelling rate is 49. 37%. Criteria B added the increasing erythrocyte sedimentation rate,elevated c-reactive protein,platelet count,total number of white blood cells,crissum inflamed skin peeling,BCG scar swelling to the dignositic criterion,and the dignositic rate at 6 days is 77. 22% compare to 56. 96% by Criteria A（ P〈0. 05）. Conclusion Combining with the increasing erythrocyte sedimentation rate,elevated c-reactive protein,platelet count,total number of white blood cells,crissum inflamed skin peeling,BCG scar redness,we can improve the early diagnostic rate of atypical Kawasaki Disease.

关 键 词：皮肤粘膜淋巴结综合征 早期诊断 参考诊断标准 

分 类 号：R725.4[医药卫生—儿科]