小儿不完全川崎病22例临床分析

目的：探讨小儿不完全川崎病的早期诊断,以及早期进行冠状动脉病变的预防治疗,减少冠状动脉瘤的发生。方法：分析2001年5月至2007年10月收住院的小儿不完全川崎病22例的临床特征、实验室检查并进行讨论。结果：全部病例在恢复期均出现指（趾）端脱皮,入院时22例患儿中9例具备包括持续发热在内的2条诊断指标,8例具备包括持续发热在内的3条诊断指标,5例具备包括持续发热在内的4条诊断指标及外周血白细胞（WBC）、C反应蛋白（CRP）、血小板升高,血沉增快;21例冠状动脉扩张、1例有冠状动脉瘤的形成。结论：小儿不完全川崎病因早期临床表现不典型,应对持续发热〉5d、抗生素治疗无效的病例进行动态超声心动图检查及随访CRP、血沉、WBC计数,作出早期诊断,减少冠状动脉病变。

A clinic analysis of 22 cases of incomplete infantile kawasaki disease

Objective: Explore how to diagnose the incomplete Kawasaki disease and preventively treat the pathological changes of coronary artery in an earlier stage,so as to reduce the incidence of coronary artery tumor.Method: Make an analysis of the clinic symptoms,lab findings and then hold a discussion concerning the 22 cases of patients hospitalized,for the incomplete Kawasaki disease,from May 2001 to October 2007.Result: All the patients in recuperating period had their fingertips or toe-ends desquamated.Upon hospitalization,9 of the 22 patients had two diagnostic indicators including sustaining fever;8 of the 22 patients had three diagnostic indicators including sustaining fever;5 of them had four diagnostic indicators including sustaining fever and WBC,CRP,rise of blood platelet,quickened subsiding of blood;21 of them had coronary artery dilated;and one of them had coronary artery tumor formed.Conclusion: As the earlier-stage clinic manifestations of the incomplete Kawasaki disease were not typical,the patients,who had sustaining fever >5d and failed to be cured by antibiotics,should be checked up through dynamic ultrasonic heart-beat graph and by tracking CPR,blood subsiding,and WBC digits,so as to have an earlier diagnosis and reduce pathological changes in coronary artery.