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[目的]分析儿童不典型川崎病的临床特点,为能尽早明确诊断提供依据。[方法]对2006年6月~2010年6月在我院诊断的49例不典型川崎病患儿的临床表现及实验室检查指标进行回顾分析,并与同期的143例典型川崎病进行比较。[结果]49例不典型川崎病均有发热,其中持续5d以上发热者47例(95.9%)。除发热外其他临床表现以眼结膜充血和口唇黏膜改变发生率最高,分别为89.8%和81.6%。实验指标中以血沉增快、外周血白细胞升高、CRP增高的发生率较高,分别为89.9%、85.7%、81.1%,常伴有血红蛋白和血浆白蛋白降低,与典型川崎病具有一致性。[结论]不典型川崎病早期表现隐匿,临床医师应具有对本病的警惕性,进行周密的临床观察,结合实验室检查综合分析,以求早诊断、早治疗,减少冠状动脉的损伤。对不明原因的发热,实验检查血沉增快,CRP增高,外周血白细胞升高,血红蛋白降低,血浆白蛋白降低,血钾、血钠水平降低可作为诊断不典型川崎病的参考指标。
[Objective] To analyze the clinical features of atypical Kawasaki disease in children and provide evidence for early diagnosis. [Method] The clinical manifestations and laboratory indexes of 49 cases of atypical Kawasaki disease diagnosed in our hospital from June 2006 to June 2010 were retrospectively analyzed and compared with 143 cases of typical Kawasaki disease in the same period. [Results] All of the 49 patients with atypical Kawasaki disease had fever, of which 47 (95.9%) had persistent fever over 5 days. In addition to fever, other clinical manifestations of conjunctival hyperemia and the highest incidence of oral mucosal changes were 89.8% and 81.6%. In the experimental indexes, the erythrocyte sedimentation rate was increased, peripheral blood leukocytes increased, and the incidence of CRP increased was 89.9%, 85.7% and 81.1% respectively, which was often accompanied by a decrease of hemoglobin and plasma albumin, which was consistent with typical Kawasaki disease . [Conclusion] The early manifestation of atypical Kawasaki disease is insidious. Clinicians should have the vigilance to this disease and make careful clinical observation. Combined with laboratory analysis, early diagnosis and early treatment can reduce the damage of coronary artery. For unexplained fever, increased ESR, increased CRP, increased peripheral leukocytes, decreased hemoglobin, decreased plasma albumin, and decreased serum potassium and serum sodium may serve as a reference for the diagnosis of atypical Kawasaki disease.