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目的总结川崎病的临床特征,以指导临床诊断、治疗。方法回顾性分析43例川崎病患儿的临床资料,总结分析其临床特征。结果所有病例均有发热,且≥5 d;典型川崎病具有≥4项诊断标准的;不完全性川崎病<4项诊断标准;所有的病例均在病程1周及2周分别检测血液白细胞(WBC)、血小板(PLT)、C-反应蛋白(CRP)、血沉等结果均较正常明显升高。结论川崎病主要见于5岁以下的小儿,18~24个月的为发病高峰,但整个儿童期均可发病,发病率逐年增加,尤其是不完全性川崎病,而不完全性川崎病主要以婴儿多见;对于持续发热>5 d,且≥2项诊断标准的,若CRP不高,血沉不增快的,需每天重新评估;若CRP升高,血沉增快,伴有以下实验室检查指标的≥3项:血象WBC升高;贫血;PLT升高;转氨酶升高;尿常规高倍镜下可见异常白细胞等,可诊断不完全性川崎病,予相关治疗,及行心脏彩超检查和动态监测;若<3项实验室检查指标的,则行心脏彩超检查,如有冠状动脉病变的即可诊断为川崎病,若没有冠状动脉病变,则每天重新评估。
Objective To summarize the clinical features of Kawasaki disease to guide clinical diagnosis and treatment. Methods The clinical data of 43 children with Kawasaki disease were retrospectively analyzed. The clinical features were analyzed. Results All patients had fever, and ≥ 5 d; Kawasaki disease had ≥ 4 diagnostic criteria; Kawasaki disease <4 diagnostic criteria; all cases were in the course of 1 week and 2 weeks were detected in the blood leukocytes WBC, PLT, C-reactive protein (CRP), erythrocyte sedimentation rate and other results were significantly higher than normal. Conclusion Kawasaki disease is mainly seen in children under 5 years of age, 18 to 24 months for the peak incidence, but the entire childhood can be morbidity, the incidence increased year by year, especially incomplete Kawasaki disease, and incomplete Kawasaki disease mainly Infants more common; for persistent fever> 5 d, and ≥ 2 diagnostic criteria, if the CRP is not high, erythrocyte sedimentation rate does not increase, need to be re-evaluated daily; if CRP increased ESR, accompanied by the following laboratory tests Indicators ≥ 3: blood WBC increased; anemia; PLT increased; elevated aminotransferases; urinary high power microscope abnormal white blood cells can be diagnosed incomplete Kawasaki disease, to be related to treatment, and underwent cardiac ultrasonography and dynamic Monitoring; if <3 laboratory test indicators, then underwent a cardiac echocardiography, coronary artery lesions can be diagnosed as Kawasaki disease, if there is no coronary lesions, the daily re-assessment.