不完全川畸病早期诊治探讨  

Clinical Research in Early Diagnosis and Treatment of Incomplete Kawasaki Disease

作　　者：杨辅直[1] 李伟生[1] 苏格炘[1] YANG Fu-zhi;Li Wei-sheng;SU Ge-xin(Department of Pediatrics,Guangdong Provincial Corps Hospital,Chinese People's Armed Police Forces,Guangzhou,510507,China)

机构地区：[1]武警广东省总队医院儿科,广东省广州市510507

出　　处：《中国全科医学》2017年第B12期87-88,共2页Chinese General Practice

摘　　要：目的探讨不完全川畸病(IKD)患儿的早期临床特点,以期做到早期诊断和治疗,改善预后。方法选取2006年5月—2016年10月武警广东省总队医院收治的IKD患儿66例为研究对象,记录临床表现和实验室检查结果,比较发热7 d内和>7 d丙种球蛋白(IVIG)和阿司匹林治疗结果及预后。结果 IKD患儿的白细胞(WBC)计数、红细胞沉降率(ESR)、丙氨酸氨基转移酶(ALT)、血清清蛋白(ALB)、血红蛋白(Hb)在病程0~3 d与病程4~7 d比较,差异无统计学意义(P>0.05),IKD患儿的血小板(PLT)、C反应蛋白(CPR)在病程0~3 d低于病程4~7 d,(P<0.05)。发热≤7 d患儿给予IVIG和阿司匹林治疗的发热时间、住院时间、冠状动脉扩张或内膜增厚低于发热>7 d(P<0.05)。结论掌握IKD临床症状和实验室指标的特点和规律,能做到早期诊断,早期大剂量丙种球蛋白治疗可缩短发热和住院时间,降低冠脉病变发生率。Objective To explore early clinical feature and in laboratory characteristics of incomplete Kawasaki disease(IKD),so that early diagnosis and treatment can be establised.Methods We enrolled 66 children with IKD in Guangdong Provincial Corps Hospital,Chinese People's Armed Police Forces from May 2006 to October 2016.The clinical and laboratory findings were recorded.The results and prognosis of 7 d and>7 D gamma globulin(IVIG)and aspirin treatment were compared.Results The WBC count,ESR,ALT,ALB and Hb of IKD children had no significant difference in the duration of 0~3 d and the 4~7 d duration(P>0.05).The PLT and CPR of children with IKD were lower than 4~7 d in the course of disease,and the difference was statistically significant(P<0.05).The heating time,heating is less than 7 d were given IVIG and aspirin in the treatment of hospitalization,dilatation of coronary artery intimal thickening or lower than that in>7 d(P<0.05).Conclusion According to the clinical features,inflammatory indicators and cardiac ultrasonography information,the IKD cases can be early diagnosised,the rate of coronary artery lesion descended if we use the aspirin and IVIG early for them.

关 键 词：黏膜皮肤淋巴结综合征 早期诊断 临床医学 

分 类 号：R725.5[医药卫生—儿科] R551.2[医药卫生—临床医学]