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目的筛选不典型与典型川崎病(KD)临床常见的主症及相关指标的变化,为川崎病的早期诊断和治疗提供参考。方法对我院儿科确诊为川崎病的68例患者(典型KD49例,不典型KD19例),进行临床主症的筛选,检测相关实验室指标及心脏彩超。并给予静脉滴注丙种球蛋白和阿司匹林联合治疗。结果典型KD临床主症以发热、球结膜充血最常见,非典型KD以发热最为常见,而实验室指标两组均有血沉、血白细胞、血小板、C反应蛋白的异常。典型KD冠状动脉的损害发生率高于非典型KD。68例中65例应用丙种球蛋白加阿司林治疗后症状控制,有3例治疗后48～72h仍有发热,加用强的松后,体温于用药3d内降至正常。结论典型KD的临床主症发生率较高,不典型KD患儿临床主症的发生率低,临床要结合KD患儿实验室指标的改变及相关治疗的效果,对疾病给予早期准确诊断和治疗。治疗首选为丙种球蛋白和阿司匹林。
Objective To screen the main clinical manifestations and related indicators of atypical Kawasaki disease (KD), and to provide references for the early diagnosis and treatment of Kawasaki disease. Methods A total of 68 patients with Kawasaki disease (KD, 49 cases, atypical KD, 19 cases) diagnosed as pediatric Kawasaki disease in our hospital were screened and the relevant laboratory parameters and echocardiography were tested. And given intravenous gamma globulin and aspirin combination therapy. Results The main clinical manifestations of typical KD fever, conjunctival hyperemia most common, the most common atypical KD to fever, and laboratory indicators of both groups were ESR, white blood cells, platelets, C-reactive protein abnormalities. The incidence of typical KD coronary arteries is higher than atypical KD. Among the 68 cases, 65 cases were treated with gamma globulin plus aspirin after symptom control, and three cases still had fever 48 ~ 72 hours after treatment. After adding prednisone, body temperature dropped to normal within three days. Conclusions The incidence of clinical main disease of typical KD is high, the incidence of clinical main disease in children with atypical KD is low, and the laboratory should be combined with the changes of laboratory indexes of KD patients and the effect of related treatment to give early accurate diagnosis and treatment of the disease . The treatment of choice for gamma globulin and aspirin.