儿童不完全川崎病的临床特点分析

Clinical features of children with incomplete Kawasaki disease

摘要:

目的 探讨不完全川崎病 （IKD）患儿的临床特点，为早期诊断该病提供可借鉴的经验。方法 回顾性分析22例住院IKD患儿的临床资料，并与同期住院的63例川崎病 （KD）患儿和20例发热患儿进行对比研究。结果 所有患儿均有发热，IKD组患儿的肢端变化、结膜充血及颈部淋巴结肿大的发生比例均显著低于KD组 （均P < 0.05）；且IKD组患儿的血清谷丙转氨酶显著高于KD组 （P < 0.05），而血浆白蛋白、血清钠、白介素6水平均显著低于KD组 （均P < 0.05）。IKD组丙球使用率与KD组无差异，而IKD组冠脉损害的发生率却显著高于KD组 （P < 0.05）。结论 IKD患儿的症状体征均不典型。肝功能检测及血钠、白介素6水平检测可能有助于IKD的诊断。

Abstract:

Objective To investigate the clinical features of children with incomplete Kawasaki disease (IKD), and to provide reference for the early diagnosis of IKD. Methods The clinical data of 22 hospitalized children with IKD were analyzed retrospectively and compared with the data of 63 children with Kawasaki disease (KD) who were hospitalized during the same period of time. Another 20 children with pyrexia were enrolled as the control group. Results Pyrexia was observed in all children. Compared with the KD group, the IKD group had significantly lower proportions of children with changes in the limbs, conjunctival hyperaemia, and cervical lymphadenectasis (P < 0.05), a significantly higher serum level of glutamic-pyruvic transaminase (P < 0.05), and significantly lower levels of plasma albumin, serum sodium, and interleukin-6 (P < 0.05). There was no significant difference in the rate of γ-globulin application between the IKD and KD groups; however, the IKD group had a significantly higher incidence rate of coronary artery lesion than the KD group (P < 0.05). Conclusions The symptoms and signs in children with IKD are untypical. The liver function test and serum hyponatremia and IL-6 measurements may be useful for the diagnosis of IKD.