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目的总结川崎病的临床特征,以指导临床治疗。方法回顾性分析2002年1月-2010年12月1 484例北京儿童医院川崎病住院患儿临床资料,总结分析其临床特征。结果北京儿童医院川崎病患儿年龄分布为2个月～14.7岁,高峰年龄为1岁;男女=1.821,复发率1.7%。6种主要临床表现中,发热为最常见临床表现,皮疹发生率最低。1 484例川崎病患儿中行2 g.kg-1IVIG初次治疗者占92.4%,其中IVIG无反应型川崎病发生率为16.9%。实验室检查中CRP升高、ESR升高、白细胞升高、贫血、血浆清蛋白降低、低钠血症、肝功能异常、心肌酶异常发生率分别为94.5%、96.4%、89.2%、72.3%、81.8%、37.9%、56.9%、27.4%。其中贫血及心肌酶升高婴幼儿发生率较高,且除贫血和肝功能异常外,其他化验指标在冠状动脉扩张发生率方面无统计学差异。冠状动脉扩张发生率为36.1%,非冠状动脉心血管并发症中,心电图异常最常见,发生率为32.3%。结论本组90%以上的川崎病患儿CRP及ESR升高,提示CRP及ESR可作为川崎病尤其是不完全川崎病的参考诊断指标,除贫血和肝功能异常外其他化验指标在冠状动脉扩张发生率方面无统计学差异,提示这2项指标在一定程度上可反映病情的轻重。
Objective To summarize the clinical features of Kawasaki disease to guide clinical treatment. Methods The clinical data of 1 484 children hospitalized with Kawasaki disease in Beijing Children’s Hospital from January 2002 to December 2010 were retrospectively analyzed. The clinical features were analyzed. Results The age distribution of children with Kawasaki disease in Beijing Children’s Hospital was from 2 months to 14.7 years old, with a peak age of 1 year. The incidence of Kawasaki disease was 1.82% in males and females, and the recurrence rate was 1.7%. Of the 6 major clinical manifestations, fever was the most common clinical manifestation with the lowest incidence of rash. 1 484 cases of children with Kawasaki disease in 2 g.kg-1IVIG initial treatment accounted for 92.4%, of which IVIG non-reactive Kawasaki disease was 16.9%. Laboratory tests elevated CRP, ESR, leukocytosis, anemia, decreased plasma albumin, hyponatremia, liver dysfunction, myocardial enzyme abnormalities were 94.5%, 96.4%, 89.2%, 72.3% , 81.8%, 37.9%, 56.9%, 27.4%. Including anemia and elevated myocardial enzymes, high incidence of infants and young children, and in addition to anemia and liver dysfunction, other laboratory indicators in the incidence of coronary artery dilation no significant difference. The incidence of coronary artery dilatation was 36.1%. Among non-coronary cardiovascular complications, electrocardiogram abnormalities were the most common, with an incidence rate of 32.3%. Conclusion CRP and ESR in more than 90% of children with Kawasaki disease in this group are elevated, suggesting that CRP and ESR may be used as a reference diagnostic indicator of Kawasaki disease, especially incomplete Kawasaki disease. Except for anemia and liver dysfunction, other laboratory markers of coronary artery dilatation The incidence of no significant difference, suggesting that these two indicators to some extent, reflect the severity of illness.