摘要
目的:比较川崎病与不完全川崎病临床特点及实验室检查结果的差异,为临床早期识别、早期诊断提供依据。方法:回顾性分析甘肃省妇幼保健院2014年1月至2018年12月确诊的川崎病(217例)和不完全川崎病(103例)患儿的临床资料,比较两组临床症状特征及实验室检查指标。结果:两组患儿发热发生率均为100.0%,但不完全川崎病组发热时间为(8.97±1.76)d,长于川崎病组的(6.60±1.01)d(t=7.68,P<0.05);不完全川崎病组结膜充血、口唇皲裂、杨梅舌及手指硬肿红斑发生率分别为82.5%(84/103)、66.9%(69/103)、21.4%(22/103)、23.3%(24/103),均低于川崎病组的94.9%(206/217)、76.9%(167/217)、75.1%(163/217)、81.1%(176/217)(χ^(2)=14.71、7.09、82.76、99.58,均P<0.05),多形性皮疹、肛周脱皮发生率分别为76.7%(79/103)、33.9%(35/103),均明显高于川崎病组的64.9%(141/217)、23.5%(51/217)(χ^(2)=4.47、3.90,均P<0.05)。不完全川崎病组患儿伴有消化系统和呼吸系统症状较川崎病组多见(P<0.05)。不完全川崎病组C-反应蛋白[(67.56±23.35)mg/L]较川崎病组[(53.91±25.06)mg/L]高(t=2.46,P<0.05),白细胞计数、血小板、B型脑钠肽较川崎病组低(t=2.00、2.34、4.69,均P<0.05)。不完全川崎病组患儿冠状动脉扩张或小型冠状动脉瘤及心包积液的发生率均高于川崎病组(χ^(2)=6.70、12.87,均P<0.05)。结论:不完全川崎病患儿发热时间长,在主要临床特征不明显的患儿中,需注意鉴别,及早诊治不完全川崎病,降低冠状动脉病变的发生率。
Objective To investigate the clinical features and laboratory examination results of complete Kawasaki disease(CKD)versus incomplete Kawasaki disease(IKD).Methods The clinical data of children with complete Kawasaki disease(CKD group,n=217)and incomplete Kawasaki disease(IKD group,n=103)who received treatment in Gansu Provincial Maternity and Child-care Hospital from January 2014 to December 2018 were retrospectively analyzed.Clinical symptom features and laboratory examination indexes were compared between the two groups.Results The incidence of fever in both groups was 100.0%,but the fever time in the IKD group was(8.97±1.76)days,which was significantly longer than(6.60±1.01)days in the CKD group(t=7.68,P<0.05).The incidences of conjunctival hyperemia,chapped lips,bayberry tongue and finger sclerosis and erythema in the IKD group were 82.5%(84/103),66.9%(69/103),21.4%(22/103),and 23.3%(24/103),which were significantly lower than 94.9%(206/217),76.9%(167/217),75.1%(163/217),and 81.1%(176/217)in the CKD group(χ^(2)=14.71,7.09,82.76,99.58,all P<0.05).The incidences of polymorphic rash and perianal peeling in the IKD group were 76.7%(79/103)and 33.9%(35/103),respectively,which were significantly higher than 64.9%(141/217)and 23.5%(51/217)in the CKD group(χ^(2)=4.47,3.90,both P<0.05).Digestive and respiratory symptoms were more common in the IKD group than in the CKD group(P<0.05).C-reactive protein level in the IKD group was(67.56±23.35)mg/L,which was significantly higher than(53.91±25.06)mg/L in the CKD group(t=2.46,P<0.05),while white blood cell count,platelet count,and B-type brain natriuretic peptide level in the IKD group were significantly lower than those in the CKD group(t=2.00,2.34,4.69,all P<0.05).The incidences of coronary artery dilation/small coronary artery aneurysm,and pericardial effusion in the IKD group were greater than those in the CKD group(χ^(2)=6.70,12.87,both P<0.05).Conclusion Children with IKD have a long time of fever.In children without obvious clinical features,attention should b
作者
张伟
宁锋锋
朱生东
王莉
Zhang Wei;Ning Fengfeng;Zhu Shengdong;Wang Li(Department of Pediatric Comprehensive Medicine,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,Gansu Province,China;Department of Anesthesia and Surgery,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,Gansu Province,China)
出处
《中国基层医药》
CAS
2023年第9期1346-1350,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
黏膜皮肤淋巴结综合征
体征和症状
发热
结膜充血
口唇皲裂
杨梅舌
C反应蛋白质
儿童
病例对照研究
Mucocutaneous lymph node syndrome
Signs and symptoms
Fever
Conjunctival hyperemia
Chapped lips
Bayberry tongue
C-Reactive protein
Child
Case-control studies
