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目的:总结6月龄以下小婴儿川崎病(Kawasaki disease,KD)的临床特征以利于早期诊断。方法:对南京市儿童医院2005年3月至2009年2月诊治的43例6月龄以下KD患儿的病历资料进行回顾性分析,并与同期诊治的6月龄以上KD患儿对比分析。结果:6月龄以下小婴儿KD 43例,男女比例2.31∶1,与同期238例6月龄以上的3组KD患儿比较,急性期卡疤红斑、消化系统症状、神经系统症状显著增多,颈淋巴结肿大显著减少,差异有统计学意义;中性粒细胞百分比(N%)、血小板(PLT)、血沉(ESR)、乳酸脱氢酶(LDH)显著升高,血色素(Hb)显著下降,差异有统计学意义;不完全KD和冠状动脉瘤样扩张发生率明显增高,差异有统计学意义。结论:6月龄以下小婴儿KD以不完全KD显著增多、冠状动脉瘤发生率增加为特征。患儿急性期要及时发现冠状动脉异常,观察卡疤红斑、消化系统、神经系统症状,监测N%、PLT、ESR、LDH、Hb等指标,以利于对6月龄以下小婴儿KD的早期诊断。
OBJECTIVE: To summarize the clinical features of Kawasaki disease (KD) in infants younger than 6 months to facilitate early diagnosis. Methods: Forty - three cases of KD children under 6 months of age treated in Nanjing Children ’s Hospital from March 2005 to February 2009 were retrospectively analyzed and compared with those of children with KD over 6 months of age treated at the same period. Results: There were 43 cases of KD in infants younger than 6 months, the ratio of male to female was 2.31:1. Compared with 238 cases of KD children over 6 months old in the same period, erythematous scar, digestive system symptoms and nervous system symptoms were significantly increased in acute stage, Cervical lymph node enlargement was significantly reduced, the difference was statistically significant; neutrophil percentage (N%), platelet (PLT), ESR, LDH increased significantly, hemoglobin (Hb) decreased significantly , The difference was statistically significant; incomplete KD and coronary aneurysm-like dilatation was significantly increased, the difference was statistically significant. CONCLUSIONS: KD in infants younger than 6 months is characterized by an incomplete KD and an increased incidence of coronary aneurysms. Children with acute phase should be promptly found abnormal coronary artery, observed card scar erythema, digestive system, nervous system symptoms, monitoring N%, PLT, ESR, LDH, Hb and other indicators in order to facilitate the early diagnosis of KD in infants younger than 6 months of age .