川崎病再发三次一例报道并文献复习  

Kawasaki Disease Recrudesced With Three Times: One Case Report and Literature Review

作　　者：史春云[1] 王建国[2] 夏明倩[1] 王冬萌[1] 

机构地区：[1]河北省保定市儿童医院,071051 [2]河北大学附属医院

出　　处：《中国全科医学》2016年第15期1841-1844,共4页Chinese General Practice

摘　　要：目的探讨川崎病再发病例的病因及临床特征。方法回顾性分析保定市儿童医院2011年3月—2014年8月川崎病再发3次患儿1例,分析其临床特点及相关实验室检查。结果本例患儿在2年半的时间内川崎病再发3次,川崎病再发时以化脓性扁桃体炎起病,有感染诱因,白细胞计数、血小板计数、C反应蛋白、红细胞沉降率均较川崎病初发时明显升高,肝功能受损无明显改变。第2次和第3次川崎病再发时均未找到明确感染因素,实验室检查示该患儿体液免疫功能及细胞免疫功能紊乱。结论临床工作中应对川崎病初发患儿加强随访,特别是出现发热等表现时,应注意观察川崎病特征性临床表现及冠状动脉病变情况,以便早期诊断川崎病再发病例,早期治疗。Objective To investigate the etiology and clinical characteristics of recurrent Kawasaki disease. Methods One child whose Kawasaki disease recrudesced with three times in Children＆#39;s Hospital of Baoding from March 2011 to August 2014 was analyzed retrospectively,the clinical characteristics and laboratory results were analyzed. Results The Kawasaki disease of this child recrudesced with three times within 2. 5 years. When Kawasaki disease recrudesced,the onset of disease was pyogenic tonsillitis,and causes of infection existed obviously,and WBC,PLT,CRP and ESR of recurrent Kawasaki disease were obviously higher than those of primary disease respectively, but the incidence of liver damage had not changed obviously. When Kawasaki disease recrudesced for the second time and third time,causes of infection were not found,but auxiliary examination results showed obvious disorders in the humoral and cellular immunity. Conclusion The children with primary Kawasaki disease should be followed up,especially when fever occurs,attention should be paid to the typical clinical manifestation of Kawasaki disease and coronary artery lesion,thus recurrent Kawasaki disease can be diagnosed and treated early.

关 键 词：川崎病 免疫 体征和症状 实验室检查 

分 类 号：R72[医药卫生—儿科]