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目的:总结婴儿川崎病(KD)临床特征,探讨我国婴儿KD诊断标准。方法:分析2002年1月~2006年7月间24例小于6月龄住院KD患儿临床资料,6~12月龄、1~5岁KD为对照,比较临床、实验室特征及诊疗情况。结果:小于6月龄组与6~12月龄组临床特征比较差异无统计学意义(P>0.05);小于6月龄组较1~5岁组眼球结合膜充血和草莓舌发生率低(χ2=8.571,P<0.05),皮疹出现时间晚(t=2.165,P<0.05),发热持续时间长(t=2.649,P<0.05);6~12月龄组较1~5岁组冠状动脉病变(CAL)发生率高(χ2=4.876,P<0.05)。结论:婴儿KD临床表现不典型,小于6月龄持续发热患儿即使无KD临床表现,亦应寻找炎症反应证据及动态观察冠脉病变,以早期诊断及改善预后。
Objective: To summarize the clinical characteristics of infant Kawasaki disease (KD) and to explore the diagnostic criteria of KD in infants in our country. Methods: The clinical data of 24 KD children younger than 6 months from January 2002 to July 2006 were analyzed. The KD between 6 and 12 months old and 1 to 5 years old were compared. The clinical and laboratory characteristics and diagnosis and treatment were compared. Results: There was no significant difference in clinical features between 6-month-old group and 6-month-old group (P> 0.05). The incidence of conjunctival hyperemia and strawberry tongue in patients younger than 6-month group was lower than that of 1- (t = 2.165, P <0.05). The duration of fever was longer (t = 2.649, P <0.05). The incidence of rash in the 6-12 months group was significantly lower than that in the 1-5 years group The incidence of arterial disease (CAL) was high (χ2 = 4.876, P <0.05). Conclusion: The clinical manifestations of KD in infants are not typical. Children with persistent fever less than 6 months of age should find evidence of inflammatory reaction and dynamic observation of coronary artery disease even in the absence of clinical manifestations of KD, so as to make early diagnosis and improve prognosis.