摘要
目的探讨川崎病(KD)的临床特征、实验室检查、冠脉损害的危险因素及治疗方法。方法对山东省立医院儿科1995年8月至2005年7月诊治的165例KD患儿资料进行了回顾性分析和总结。结果165例KD中典型136例,不典型29例,男114例,女51例,男女比例约为2.2∶1。年龄最小23d,最大11岁。<1岁41例,1～3岁68例,>3～5岁23例,>5岁33例。平均发病年龄2岁8个月。合并冠脉损害者44例,其中冠脉扩张26例,冠脉瘤13例,巨大冠脉瘤5例。对合并冠脉损害者随访6个月至3年,完全恢复正常者40例,5例巨大冠脉瘤患者,1例完全恢复,其余4例未恢复,1例合并冠脉血栓形成。结论不典型KD冠脉损害率高,KD发病10d内用丙球效果好,2g/kg单次注射明显优于0.4g/(kg.d)连用5d的疗法,WBC升高、ALB降低、男性及发热时间长是KD合并冠脉损害的危险因素。
Objective To investigate the clinical features,laboratory examination, risk factors of coronary artery lesions and treatment for Kawasaki disease. Methods A total of 165 patients with Kawasaki disease hospitalized in Shandong Provincial Hospital during August 1995 and July 2005 were reviewed. Results Among 165 cases, 136 were diagnosed with typical KD and 29 atypical（incomplete） KD;114 were male and 51 were female,male to female ratio is 2. 2： 1. The age was between 23 days and 11 years old;41 cases was under 1 year old,68 between 1 to 3 years old,23 between 3 -5 years old 33 over 5 years old. The mean age was 2 years and 8 months old. Totally 44 cases were complicated with coro- nary artery lesions,including 26 coronary artery dilations, 13 coronary artery aneurysms and 5 giant coronary artery aneurysms. The patients with CA lesions were followed up from 6 months to 3 years,40 cases regressed completely, 1 of 5 cases with giant CA aneurysm regressed completely, and other 4 cases didnt regress, 1 case complicated with coronary thrombosis. Conclusion Atypical KD has higher prevalence of CA lesions. Children receiving IVIG 2g/kg in the early 10 days of KD has little chance of CAL. The single dose of 2g/kg IVIG administration has better outcome. The risk factors of CA lesions include high WBC count,low ALB level, male children and persistent fever.
出处
《中国实用儿科杂志》
CSCD
北大核心
2008年第10期750-753,共4页
Chinese Journal of Practical Pediatrics
关键词
川崎病
不典型川崎病
冠脉损害
丙种球蛋白
Kawasaki disease
Atypical Kawasaki disease
Coronary artery lesions
Gamma globulin
