川崎病休克综合征25例临床特征分析  

Analysis on clinical characteristics in 25 cases of Kawasaki disease shock syndrome

作　　者：曹骄阳 李永钦[1] CAO Jiaoyang;LI Yongqin(Department of Emergency,Affiliated Children′s Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Medical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院急诊科/儿童发育疾病研究教育部重点实验室/国家儿童健康与疾病临床医学研究中心/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室,重庆400014

出　　处：《现代医药卫生》2021年第8期1292-1296,1301,共6页Journal of Modern Medicine & Health

摘　　要：目的分析川崎病休克综合征(KDSS)的临床特征,以提高KDSS诊疗水平并为机制研究提供更多临床资料。方法收集2018年1月至2019年12月该院住院治疗的25例KDSS患儿的临床资料,回顾性分析KDSS流行病学和临床特点。结果25例患儿平均年龄(4.22±2.55)岁,女性占60.00%(15/25),平均高热持续时间(8.08±2.40)d,平均发热(5.60±1.33)d后出现休克;炎症指标增高,伴低清蛋白血症、低钠血症和低钾血症;40.00%(10/25)的患儿合并冠状动脉瘤,32.00%(8/25)的患儿为不完全川崎病,76.00%(19/25)的患儿有明显腹部症状。25例患儿均使用静脉注射丙种球蛋白(IVIG)联合阿司匹林口服、液体复苏治疗等,且56.00%(14/25)的患儿对IVIG无反应,无死亡病例。结论KDSS患儿有严重的炎性反应表现,容易出现脏器功能损害,甚至功能衰竭,腹部症状明显,容易发生冠状动脉损伤及对IVIG治疗无反应。Objective To analyze the clinical characteristics of Kawasaki disease shock syndrome(KDSS)to increase the diagnostic and treatment level of KDSS and provide more clinical data for the study of pathogenesis mechanism.Methods The clinical data in 25 hospitalized cases of KDSS in this hospital from January 2018 to December 2019 were collected.The epidemiology and clinical characteristics of KDSS were retrospectively analyzed.Results The average age in 25 cases was(4.22±2.55)years old and the females accounted for 60.00%(15/25).The average high fever duration was(8.08±2.40)d and shock appeared after average fever(5.60±1.33)d.The inflammatory indicators were increased,which was accompanied by hypoalbuminemia,hyponatremia and hypokalemia.40.00%(10/25)of the children patients were complicated with coronary artery aneurysms,32.00%(8/25)of the children patients were incomplete KD,and 76.00%(19/25)of the children patients had the abdominal symptoms.Twenty-five cases all used intravenous immunoglobulin(IVIG)combined with oral aspirin,liquid resuscitation,etc.,moreover 56.00%(14/25)of the cases had no response to IVIG.No death case occurred.Conclusion The children cases of KDSS have severe inflammatory manifestations,even the function failure,the abdominal symptoms are obvious,is easy to develop the coronary arterial injury and no response to IVIG.

关 键 词：川崎病休克综合征 休克 冠状血管损伤 临床特征 儿童 

分 类 号：R725.4[医药卫生—儿科]