川崎病64例临床分析  

Clinical analysis of Kawasaki disease in 64 cases

作　　者：孔艳冉 李腾腾 李慧 KONG Yanran;LI Tengteng;LI Hui(Department of Pediatrics,Second Affiliated Hospital of Shandong First Medical University,Taian,Shandong,271000,China)

机构地区：[1]山东第一医科大学第二附属医院儿内科,山东泰安271000

出　　处：《当代医学》2024年第3期156-159,共4页Contemporary Medicine

摘　　要：目的分析64例川崎病(KD)患儿的临床特点,并结合国内外新诊疗进展,总结其临床特征以减少误诊、漏诊。方法回顾性分析2016年1月至2021年1月山东第一医科大学第二附属医院儿科收治的64例KD患儿的临床资料,包括人口学特征、临床表现及体征、实验室及影像学检查、临床治疗及疾病转归,总结KD临床特征。结果64例患儿中男34例(53.16%),女30例(46.84%);婴幼儿期(<3岁)43例(67.19%);所有患儿均有发热,球结膜充血34例(53.13%)、口唇皲裂、草莓舌36例(56.25%)、皮疹47例(73.44%),其中卡疤红肿6例(9.38%)、颈部淋巴结肿大37例(57.81%)、手足硬性水肿35例(54.69%)、指/趾端脱皮42例(65.63%)。白细胞计数(10~30)×109/L者45例,以中性占优势;血小板计数>300×109/L者49例;C反应蛋白>30mg/L者48例;肝功能检查转氨酶增高15例;18例淋巴细胞亚群检查B细胞活化10例;冠状动脉扩张14例,未发现形成冠状动脉瘤者;64例患儿中有57例于急性期使用丙种球蛋白2g/kg冲击治疗,其中4例不敏感,2例给予第2剂丙种球蛋白后体温稳定,另2例加强抗感染后体温稳定;64例均使用阿司匹林治疗。结论KD好发年龄<5岁儿童,男童多于女童,KD可累及全身多个系统,尤其对于不完全川崎病患儿需要结合临床表现、体征及生化指标做到早期确诊;早期应用丙种球蛋白结合阿司匹林治疗,多数患儿预后良好。Objective The clinical characteristics of 64 children with Kawasaki disease(KD)were analyzed,and combined with the new diagnosis and treatment progress at home and abroad,the clinical characteristics were summarized to reduce misdiagnosis and missed diagnosis.Methods The clinical data,including demographic characteristics,clinical manifestations and signs,laboratory and imaging examinations,clinical treatment and disease outcomes of 64 children with KD admitted to the Second Affiliated Hospital of Shandong First Medical University from January 2016 to Jan-uary 2021 were retrospectively analyzed,and the clinical characteristics of KD were summarized.Results Among the 64 patients,34 cases(53.16%)were males and 30 cases(46.84%)were females;infant stage(<3 years old)43 cases(67.19%);all the children had fever,bulboconjuncti-val congestion in 34 cases(53.13%),lip chapping,strawberry tongue in 36 cases(56.25%)and rash in 47 cases(73.44%),among them,there were 6 cases(9.38%)of scar red swelling,37 cases(57.81%)of neck lymph node enlargement,35 cases(54.69%)of hands and feet stiff swelling,and 42 cases(65.63%)of finger and toe peeling.Leukocyte(10-30)×109/L was predominant in 45 cases,neutral predominates;49 cases with platelet>300×109/L;48 cases with C-reactive protein>30 mg/L,liver function examination increased aminotransferase in 15 cases;B-cell activation was detected in 10 of 18 lymphocyte subsets.Coronary artery dilation occurred in 14 cases,and no coronary aneurysm was found;among the 64 cases,57 cases were treated with gamma globulin 2 g/kg shock therapy in the acute stage,4 cases were insensitive,2 cases were stable after receiving the second dose of gamma globulin,and the other 2 cases were stable after strengthening anti-infection;all 64 cases were treated with aspirin.Conclusion The preference age of KD is<5 years old,more boys than girls,KD can involve multiple systems throughout the body,especially for children with in-complete Kawasaki disease,it is necessary to combine clinical manifestations,signs and

关 键 词：川崎病 不完全川崎病 难治性川崎病 

分 类 号：R725.4[医药卫生—儿科]