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5岁以上儿童川崎病的临床分析

刘力,李崇巍,马继军,李维超,曹阳   

  1. 天津市儿童医院
  • 收稿日期:2013-07-15 修回日期:2013-08-24 出版日期:2014-01-15 发布日期:2014-01-15
  • 通讯作者: 刘力

The clinical analysis of Kawasaki disease in children above 5 years

  • Received:2013-07-15 Revised:2013-08-24 Published:2014-01-15 Online:2014-01-15
  • Contact: Li LIU

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摘要： 目的 对比分析5岁以上儿童川崎病 （KD） 的临床及实验室特征， 旨为临床早期诊治提供依据。方法 回顾性分析我科≥5岁 （≥5岁组， 50例） 和＜5岁 （＜5岁组， 211例） KD患儿的性别差异、 主要临床表现、 实验室及物理检查结果、 不完全型KD比例、 静脉注射免疫球蛋白 （IVIG） 无反应KD比例、 冠状动脉病变 （CAL） 发生率。结果 ≥5岁组患儿的性别比例、 不完全KD发生率、 首次IVIG无反应发生率、 CAL发生率与＜5岁组比较差异均无统计学意义 （P＞0.05）。≥5岁组患儿的淋巴结肿大发生率 （90%） 高于＜5岁组 （69.2%）， 肛周改变 （16%） 及卡痕红斑 （0）发生率低于＜5岁组 （分别为33.6%和20.9%）， 差异有统计学意义 （P＜0.05）。结论 5岁以上KD患儿的淋巴结肿大较5岁以下患儿多见， 肛周皮肤潮红继之脱屑、 卡痕红斑较5岁以下患儿少见， 5岁以上发热超过5 d的患儿需要警惕KD的可能。

关键词: 川崎病, 临床特征, 回顾性分析, 儿童

Abstract: Objective For early diagnosis of Kawasaki disease(KD) and to decrease the misdiagnosis rate，this article analyzed clinical features of Kawasaki disease in the children above 5 years. Methods The clinical data of children above 5 years suffering from Kawasaki disease, whom hospitalized in tianjin pediatrics hospital from 2006 to 2010,were retrospectively analyzed and compared with the data of children under 5 years with KD。The contrast items included sex ratio,clinical situation,laboratories and physical examination,atypia/incomplete KD ratio,IVIG resistant ratio and coronary artery lesion(CAL) incidence. Results There were no differences in sex ratio, atypia KD ratio,IVIG resistant ratio and CAL．Skin of perianal area appeared flush and succedented desquamation was benefit to diagnosis of KD aged above 5 years. BCG vaccination scar appeared flush was not recorded in the patients above 5 years. Incidence rate of lymphadenectasis was higher in the patients above 5 years(p<0.05).The incidence of CAL with atypia /incomplete KD aged above 5 years was higher(80%)。Conclusion Lymphadenectasis and flush succedented desquamation of perianal area were frequently observed in the children aged above 5years. Atypia /incomplete KD aged above 5 years presented higher incidence of CAL than typical patients.KD should be regarded with differential diagnosis in fever unknow cases whose age above 5 years.

Key words: Kawasaki disease, clinical features, etrospective analyses, children