2010年至2019年住院川崎病3498例回顾性分析  

A retrospective analysis of 3 498 hospitalized patients with Kawasaki disease from 2010 to 2019

作　　者：吕爱婷 何坤 王芳洁 侯维纳[1] 贾丽娟 LYU Ai-ting;HE Kun;WANG Fang-jie;HOU Wei-na;JIA Li-juan(Department of Cardiovascular Medicine,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450066,China)

机构地区：[1]郑州大学附属儿童医院心血管内科,郑州450066

出　　处：《医药论坛杂志》2023年第3期9-12,16,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划项目(2018020695)。

摘　　要：目的 分析郑州大学附属儿童医院近10年来住院川崎病(Kawasaki disease, KD)病例的临床特点及其变化规律,以提高KD的诊治水平。方法 回顾性分析2010年1月1日至2020年1月1日郑州大学附属儿童医院收治的3 498例KD患儿临床资料,以2015年1月1日为分界点,2015年1月1日后的病例为观察组(2 356例),2015年1月1日前的病例为对照组(1 142例)。比较两组流行病学特征(发病月份、年龄、KD类型、性别)、临床表现(手足硬肿、发热、颈部淋巴结肿大、皮疹、结膜充血、肛周及指(趾)端脱皮、口腔黏膜改变)、并发症(包括冠脉损害(CAL)、间质性肺炎、无菌性脑炎、关节炎、肝损害、腮腺炎、无菌性脓尿)、实验室检查指标[白细胞计数(WBC)、血小板计数(PLT)、C反应蛋白(CRP)、血沉(ESR)、谷丙转氨酶(ALT)、降钙素原(PCT)、脑钠肽(BNP)]以及静脉注射丙种球蛋白(Intravenous immunoglobulin, IVIG)不敏感发生率。结果 观察组与对照组间年龄、不完全型KD以及发病月份相比差异有统计学意义(P<0.05);观察组皮疹、口腔黏膜变化、手足硬肿发生率低于对照组(P<0.05);两组间实验室指标WBC、PLT、CRP、ESR、ALT、PCT、BNP差异无统计学意义(P>0.05);观察组合并CAL的发生率13.24%高于对照组8.49%(P<0.05);观察组IVIG不敏感发生率为19.10%,高于对照组的13.22%(P<0.05)。结论 近10年不完全型KD病例增加,且2015年1月1日后l岁内婴儿KD,冠状动脉损害以及IVIG不敏感发生率增高,临床上应及早作出诊断,及时治疗,减少并发症的发生。Objective To analyze the clinical characteristics and variation of Kawasaki disease(KD) cases in our hospital in recent 10 years, in order to improve the diagnosis and treatment level of KD, especially incomplete KD. Methods The clinical data of 3 498 children with KD admitted to our hospital from January 1, 2010 to January 1, 2020 were retrospectively analyzed. Taking January 2015 as the cut-off point, the cases after January 1, 2015 were set as the observation group(2 356 cases), and the cases before January 1, 2015 were set as the control group(1 142 cases). The epidemiological characteristics(month of onset, age, KD type, and gender), clinical manifestations(Hand and foot swelling, fever, neck lymph node enlargement, rash, conjunctival congestion, perianal and finger(toe) end peeling, oral mucosa changes), complications(coronary artery lesions, interstitial pneumonia, sterile encephalitis, arthritis, liver damage, mumps, and sterile pyuria), laboratory tests [white blood cell count(WBC), platelet count(PLT), C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), alanine aminotransferase(ALT), procalcitonin(PCT), brain natriuretic peptide(BNP)] and the incidence of Intravenous immunoglobulin(IVIG) insensitivity were compared between the two groups. Results There were significant differences in age, incomplete KD and onset month between the observation group and the control group(P<0.05). The incidence of rash, oral mucosa changes, and hard swelling of hands and feet in the observation group was lower than that in the control group(P<0.05). There were no significant differences in WBC, PLT, CRP, ESR, ALT, PCT and BNP between the two groups(P>0.05). The incidence of CAL in the observation group was 13.24%, which was higher than 8.49% in the control group(P<0.05). The incidence of IVIG insensitivity in the observation group was 19.10%, which was higher than 13.22% in the control group(P<0.05). Conclusion The incidence of incomplete KD increased in recent 10 years, and the incidence of KD, coronary artery l

关 键 词：川崎病 不完全型川崎病 冠状动脉损害 回顾性分析 

分 类 号：R725.4[医药卫生—儿科]