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目的探讨不完全川崎病(IKD)的早期诊断和临床特征,以提高川崎病(KD)的早期诊断率,减少KD延迟诊断及冠状动脉病变(CAL)的发生。方法对2000年1月-2010年1月收治的42例IKD患儿和147例典型KD进行回顾性分析。分别对IKD和典型KD患儿的年龄、性别、临床特点[包括发热、淋巴结大、指(趾)端脱皮、球结膜充血、手足硬性水肿、皮疹、口腔黏膜充血、肛周脱屑、卡介苗接种处再现红斑(卡疤红肿)]、实验室特点[包括血WBC计数、Hb、PLT计数、ESR、CRP、血清清蛋白(Alb)、血清ALT、血钠]、心脏彩超及心电图等临床资料进行比较。应用SPSS 17.0软件对数据进行统计学处理。结果 IKD组与典型KD组比较发病无性别差异,但发病年龄小;IKD组诊断时发热持续时间长;IKD组急性期手足硬肿、口腔黏膜充血、球结膜充血、皮疹方面低于典型KD组,而卡疤红肿则多于典型KD组;IKD组WBC计数及CRP较典型KD组高;2组心电图异常比较差异无统计学意义,但IKD组发生CAL高于典型KD组。结论 IKD患儿CAL发生率高,小年龄、发热时间长、卡疤红肿、WBC计数及CRP明显升高有助于IKD诊断。尽早完善相关实验室检查可减少IKD延迟诊断及CAL发生。
Objective To investigate the early diagnosis and clinical features of incomplete Kawasaki disease (IKD) in order to improve the early diagnosis rate of KD and reduce the delayed diagnosis of KD and the occurrence of coronary artery disease (CAL). Methods 42 cases of IKD and 147 cases of typical KD admitted from January 2000 to January 2010 were retrospectively analyzed. Age, sex and clinical features of IKD and typical KD children [including fever, lymph node enlargement, nail peeling, bulbar conjunctival congestion, hand-foot edema, rash, oral mucosal congestion, perianal desquamation, BCG vaccination Erythrocytes (scar swelling)], laboratory features [including blood WBC count, Hb, PLT count, ESR, CRP, serum albumin (Alb), serum ALT, serum sodium], echocardiography and other clinical data Compare The data were statistically processed using SPSS 17.0 software. Results Compared with the typical KD group, the IKD group showed no significant difference in age, but the onset age was small. The duration of fever in IKD group was longer than that in the typical KD group. The acute stage of IKD group was lower than the typical KD group , But scarring was more in KD group than in typical KD group. WBC count and CRP in IKD group were higher than those in typical KD group. There was no significant difference in ECG abnormalities between two groups, but CAL in IKD group was higher than that in typical KD group. Conclusions The incidence of CAL in children with IKD is high, with younger age, longer fever, scar swelling, WBC count and CRP. It is helpful for IKD diagnosis. As soon as possible to improve the relevant laboratory tests can reduce IKD delay diagnosis and the occurrence of CAL.