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目的分析学龄儿童川崎病的临床及实验室特点,提高对学龄儿童川崎病的认识。方法采用回顾性调查法分析比较6个月～5岁儿童及≥6岁确诊为川崎病患儿有关的临床资料,并进行分组对比。结果高年龄组患儿临床表现:球结膜充血、口唇改变、指(趾)端改变、手足硬肿、皮疹、颈部淋巴结大的发生率较低年龄组低。实验室检查:高年龄组中白细胞[(5～10)×109 L-1]、CRP(>5 mg.L-1)、ESR[(20～80)mm.(1 h)-1]3项指标的发生率较低年龄组低;高年龄组中白细胞(>10×109 L-1)、CRP(0～5 mg.L-1)、ESR[0～20 mm.(1 h)-1]3项指标的发生率高于低年龄组。心脏彩色多普勒:高年龄组冠状动脉瘤、心脏结构改变、心包积液的发生率较低年龄组高,差异均有统计学意义。结论学龄儿童川崎病临床表现不典型,缺乏早期诊断特异指标,易造成漏诊及延误治疗,导致冠状动脉瘤发病率较高。对学龄期儿童发热应引起足够重视,必要时进行全面检查,心脏彩色多普勒检查是确诊川崎病心脏病变简单可行的方法。
Objective To analyze the clinical and laboratory features of Kawasaki disease in school-age children and to raise awareness of Kawasaki disease in school-age children. Methods The clinical data of children aged 6 months to 5 years and children diagnosed as Kawasaki disease ≥ 6 years old were analyzed retrospectively and compared with each other. Results The clinical manifestations of children in high age group: conjunctival hyperemia, changes in the lips, toe changes, hand and foot sclerosis, rashes, cervical lymph node large incidence of lower age group. Laboratory tests showed that white blood cells [(5 to 10) × 109 L-1], CRP (> 5 mg.L-1) and ESR [(20 to 80) mm. The incidence rate of the index was lower in the lower age group. The levels of white blood cells (> 10 × 109 L-1), CRP (0-5 mg.L-1), ESR [0-20 mm 1] The incidence of three indicators is higher than the lower age group. Cardiac color Doppler: Coronary artery aneurysm in high age group, cardiac structure changes, the incidence of pericardial effusion was lower in the age group, the differences were statistically significant. Conclusions The clinical manifestations of Kawasaki disease in school-age children are not typical, and the lack of early diagnosis of specific indicators easily lead to missed diagnosis and delayed treatment, resulting in a higher incidence of coronary aneurysms. On school-age children should pay enough attention to fever, if necessary, a comprehensive examination of cardiac color Doppler examination is a simple and feasible method of diagnosis of Kawasaki disease.