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目的了解不典型川崎病(KD)的早期临床表现,提高不典型川崎病的早期诊断水平,降低儿童后天性心脏病的发病率。方法将本院2008年1月至2014年7月收治的79例川崎病进行回顾性临床分析,分别用A、B两种诊断标准(A为传统诊断标准、B为参考诊断标准)对其进行分析。结果实验室检查指标异常率依次为红细胞沉降率增快(91.14%)、C反应蛋白升高(88.61%)、血小板计数升高(87.34%)、白细胞总数升高(86.08%);传统诊断标准以外的常见的临床表现中,肛周红肿脱皮发生率为53.17%,卡介苗瘢痕红肿发生率为49.37%。B标准将红细胞沉降率增快、C反应蛋白升高、血小板计数升高、白细胞总数升高、肛周红肿脱皮、卡介苗瘢痕红肿纳入参考诊断标准,其在发病第6天诊断率与A标准比较由56.96%提高到77.22%(P<0.05)。结论结合红细胞沉降率增快、C反应蛋白升高、血小板计数升高、白细胞总数升高、肛周红肿脱皮、卡介苗瘢痕红肿,可提高对不典型川崎病的早期诊断率。
Objective To understand the early clinical manifestations of atypical Kawasaki disease (KD), improve the early diagnosis of atypical Kawasaki disease and reduce the incidence of acquired heart disease in children. Methods A total of 79 cases of Kawasaki disease admitted from January 2008 to July 2014 in our hospital were retrospectively analyzed. The diagnostic criteria were A and B respectively (A was the traditional diagnostic criteria and B is the reference diagnostic criteria) analysis. Results The abnormal rates of laboratory tests were as follows: erythrocyte sedimentation rate (91.14%), C reactive protein (88.61%), platelet count (87.34%) and total leukocyte count (86.08% Other common clinical manifestations, the incidence of perianal erythema peeling was 53.17%, the incidence of BCG scarring was 49.37%. B standard erythrocyte sedimentation rate increased, elevated C-reactive protein, elevated platelet count, increased total white blood cells, perianal redness and peeling, BCG scar swelling into the reference diagnostic criteria, the incidence of diagnosis on the 6th day and A standard comparison From 56.96% to 77.22% (P <0.05). Conclusion Combined with the rapid increase of erythrocyte sedimentation rate, elevated C-reactive protein, increased platelet count, increased leukocyte count, perianal erythematosus and scarring of BCG scar may improve the early diagnosis of atypical Kawasaki disease.