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目的:探讨儿童川崎病(Kawasaki disease,KD)的临床诊断和治疗方法,了解KD临床表现与预后的关系。方法:对54例川崎病患儿的临床表现进行分析,联合应用大剂量丙种球蛋白(IVIG)和阿司匹林进行治疗。随访观察KD患儿外周血WBC、PLT、CRP和ESR的变化与冠状动脉病变(CAL)的关系。结果:发热是该病最早最明显的症状,54例均有发热(100%),发热期均在5天以上。结合膜充血、杨梅舌、淋巴结肿大发生率较高,分别为95%、96%、96%,60%以上患者有皮疹、指趾端硬性水肿、脱皮。实验室检查发现WBC、PLT、CRP和ESR均明显增高;54例KD中并发CAL 10例(18.5%),相关因素分析显示发病年龄、性别、血沉、血小板、C反应蛋白与CAL发生率有密切关系。结论:对于典型川崎病可以根据诊断标准确诊,大剂量丙种球蛋白治疗川崎病有显著疗效,阿司匹林具有抗炎、抗凝、抑制血小板聚集的作用,是治疗KD的主要药物。血沉、血小板、C反应蛋白明显升高是CAL的高危因素,3岁以下男性更易罹患CAL。
Objective: To explore the clinical diagnosis and treatment of Kawasaki disease (KD) in children and to understand the relationship between clinical manifestations and prognosis of KD. Methods: The clinical manifestations of 54 children with Kawasaki disease were analyzed and treated with high dose of IVIG and aspirin. Follow-up observation of peripheral blood WBC, PLT, CRP and ESR changes and coronary artery disease (CAL) Results: Fever was the earliest and most obvious symptom of the disease. All 54 patients had fever (100%) and the fever period was more than 5 days. Combined with membrane congestion, bayberry tongue, the incidence of lymphadenopathy were higher, 95%, 96%, 96%, 60% of patients with rash, toe hard edema, peeling. Laboratory tests showed that the WBC, PLT, CRP and ESR were significantly increased; 54 cases of KD complicated by CAL in 10 cases (18.5%), related factors analysis showed age, gender, ESR, thrombocytopenia, C-reactive protein and CAL incidence were close relationship. CONCLUSIONS: Kawasaki disease can be diagnosed according to the diagnostic criteria. High doses of gamma globulin are effective in treating Kawasaki disease. Aspirin is an anti-inflammatory, anticoagulant and platelet aggregation inhibitor. It is the main drug for KD treatment. Erythrocyte sedimentation rate, platelet, C-reactive protein is a high risk factor for CAL, men under the age of 3 are more likely to have CAL.