完全性川崎病与不完全性川崎病患儿临床特点比较

摘要

目的 比较完全性川崎病与不完全性川崎病患儿临床特点.方法 选取2013年1月至2016年12月在广州中医药大学附属中山中医院就诊的58例川崎病患儿,对比分析完全性与不完全性川崎病的临床特点及转归,比较其差异.结果 完全性川崎病患儿皮疹、口腔黏膜充血、急性期手足硬肿、球结膜充血等症状的发生率较不完全性川崎病患儿高(76.67% vs. 28.57%、83.33% vs.42.86%、76.67% vs.50.00%、93.33% vs.50.00%),卡疤红肿发生率较不完全性川崎病患儿低(16.67% vs. 32.14%),差异均有统计学意义(χ2值分别为25.998、32.567、11.786、97.988、3.949,均 P<0.05).不完全性川崎病患儿白细胞计数、C反应蛋白(CRP)较完全性川崎病患儿高,差异均具有统计学意义(t值分别为4.565、3.062,均 P<0.01).两组患儿心电图异常发生率比较差异无统计学意义(χ2=2.869,P>0.05),不完全性川崎病患儿冠状动脉病变发生率显著高于完全性川崎病患儿(χ2=6.536,P<0.05).结论 不完全性川崎病患儿发热时间长,CRP水平、卡疤红肿发生率、白细胞计数明显升高,冠状动脉病变发生率高,有助于其早期诊断.尽早完善相关实验室检查可减少其误诊漏诊及冠状动脉病变发生.%Objective To compare the clinical characteristics of complete and incomplete Kawasaki disease.Methods From January 2013 to December 2016,58 children with Kawasaki disease in Zhongshan City Chinese Medicine Hospital of Guangzhou University of Chinese Medicine were selected.The clinical features and outcomes of the cases with complete and incomplete Kawasaki disease were compared and analyzed.Results The incidence rates of rash,oral mucosal congestion,acute scleredema and conjunctival congestion of complete Kawasaki disease group were higher than those of incomplete Kawasaki disease group(76.67% vs 28.57%, 83.33% vs 42.86%,76.67% vs 50.00%,93.33% vs 50.00%),while the incidence rate of vaccinated scar redness was lower (16.67% vs.32.14%)with significant differences(χ2value was 25.998,32.567,11.786,97.988 and 3.949,respectively,all P<0.05).White blood cell count and C-reactive protein(CRP)of incomplete Kawasaki disease group were higher than complete Kawasaki disease group with statistical significance(t value was 4.565 and 3.062,respectively,both P<0.01).There was no significant difference in abnormal rate of electrocardiogram between two groups(χ2= 2.869,P> 0.05).Incidence of coronary artery lesions of incomplete Kawasaki disease group was significantly higher than complete Kawasaki disease group(χ2=6.536, P>0.05).Conclusion Cases with incomplete Kawasaki disease have longer fever time,higher level of CRP,higher incidence of vaccinated scar redness,higher white blood cell count and higher incidence of coronary artery lesions,which are helpful for early diagnosis.Misdiagnosis,missed diagnosis and incidence of coronary artery disease could be reduced through early laboratory examinations.