典型川崎病与不完全川崎病的临床特点单中心比较分析

摘要

目的 分析本中心50例典型川崎病和16例不完全川崎病的临床表现和实验室检查结果,为川崎病的早期诊断、早期治疗提供依据.方法 回顾性分析2013年3月至2017年7月在本中心收治的50例典型川崎病和16例不完全川崎病患儿,分析比较两组患儿临床症状特点;分析两组患儿基本的实验室检查指标;分析两组患儿在活动期冠状动脉病变(CAL)情况.结果 ①典型川崎病组和不完全川崎病组患儿确诊时发热的天数、年龄差异均具有统计学意义(P<0.05);②不完全川崎病组的临床症状如皮疹、颈部淋巴结非化脓性肿大、唇充血和草莓舌、手足硬性水肿和脱皮的发生率显著低于典型川崎病组(P<0.05);③两组血清天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、乳酸脱氢酶(LDH)比较差异有统计学意义(P<0.001).④不完全川崎病组中冠状动脉扩张率显示高于典型川崎病组(40.0％vs 81.3％)(P<0.05).结论 不完全川崎病易发生于年龄小的男童,且不完全川崎病的冠脉扩张率明显高于典型川崎病.%Objective To review 50 cases of complete Kawasaki disease and 16 cases of incomplete Kawasaki disease and analyze the clinical features and laboratory results,so as to provide evidences for early diagnosis and treatment of Kawasaki disease.Methods The data of 16 patients with incomplete Kawasaki disease (IKD group)and 50 patients with complete Kawasaki disease (CKD group)were analyzed from March,2013 to July,2017,and the clinical manifestations,laboratory indicators,and incidence of coronary artery lesion (CAL)were compared.Results① There were significant differences between IKD group and CKD group in the days of fever from diagnosis and age (P < 0.05 ); ② In IKD group, the incidences of the clinical manifestations including erythematous rash, lymphadenectasis of neck,lips and tongue changes,and edema induratum and desquamation in fingers and toes were lower than those in CKD group(P < 0.05 );③ There were significant differences in glutamic-pyruvic transaminase (ALT),lactate dehydrogenase (LDH),aspartate aminotransferase (AST)between IKD group and CKD group (P <0.05);④ The incidence of coronary artery dilation was 40.0％ vs 81.3％ in CKD group and IKD group,respectively (P <0.05).Conclusion The morbidity of incomplete Kawasaki disease is higher among younger boys;the incidence of coronary artery dilation is significantly higher in incomplete Kawasaki disease than in complete Kawasaki disease.