川崎病临床表现与早期诊断的探讨

Early Diagnosis and Clinical Manifestation of Kawasaki Disease

摘要:

目的：探讨建立一种早期诊断川崎病(KD)的诊断指标的可能性。方法：参照KD现行诊断标准，统计分析69例KD患儿各种临床表现出现的时间及发生率。结果：本病早期发热、唇红和或干裂、皮疹、眼结膜充血的发生率分别为100%，92.8%，84%，81%；肛周皮肤潮红和/或脱皮96%出现在起病8 d内，卡介苗接种疤痕(卡疤)反应常在起病3 d内出现。结论：KD患儿发热、皮肤粘膜改变是主要临床表现，当出现发热、唇红干裂、眼结膜充血的“川崎面容”时即应高度怀疑KD的可能。肛周皮损及“卡疤”反应具有早期诊断的价值。

Abstract:

OBJECTIVE: To explore the possibility of making an early diagnosis on Kawasaki disease (KD). METHODS: Medical records of 69 children with KD were reviewed retrospectively. Diagnosis of KD was based on current diagnostic criteria of KD. RESULTS: In the 69 cases of KD the incidence of fever, lips injection and/or cheilosis, skin rashes, and bilateral nonexudative conjunctival injection were 100%, 92%, 84% and 81% respetfively within 5 days since onset. The incidence of the perianal skin redness and/or desquamation appeared in 8 days after onset and BCG inoculation scar reaction——“BCG scar” reaction appeared earlier (in 3 days after onset). CONCLUSIONS: When a child developed the Kawasaki appearance—fever, bilateral nonexudative conjunctival injection and lips injection and/or cheilosis in the early stage of febrile illness, KD should be highly suspected. “BCG scar reaction” and the perianal skin redness, even desquamation may be helpful to make an early diagnosis of KD.