摘要
目的探讨川崎病早期诊断。方法对52例KD患儿各种临床表现出现的时间及有关实验室指标进行分析,提出早期诊断KD的依据。结果发病早期≤3d卡介苗接种处发红、硬结2例(3.8%);<3岁患儿肛门、阴囊皮肤潮红、糜烂的发生率极显著高于>3岁的患儿;>3岁患儿淋巴结肿大的发生率极显著高于<3岁患儿。≤5d发热52例(100.0%),皮肤表现45例(86.5%),唇红皲裂40例(76.9%),球结膜充血39例(75.0%),血沉增快46例(88.5%),白细胞升高44例(84.6%),C反应蛋白升高42例(80.8%);心脏冠脉病变3例发生在5～7d;6例查D-二聚体均升高。40例(76.9%)在早期≤7d做出了明确诊断。结论卡介苗接种处发红、硬结及<3岁患儿肛门、阴囊皮肤潮红、糜烂是KD患儿早期较特异的临床表现;淋巴结肿大在>3岁患儿较常见。发热、皮肤表现、唇红、皲裂、眼结膜充血、血沉增快、白细胞升高、C反应蛋白升高、D-二聚体升高具有早期诊断的价值;当早期高度怀疑KD的可能时,应尽早行心脏超声检查。
Objective To investigate the early diagnosis for Kawasaki disease. Methods Time that diversified clinical manifestation emerged and correlative laboratory data in 52 cases were analysed to find the ways of early diagnosis for KD. Results 2 cases（3.8%） were involved in the reddened and sclerotic tubercles of BCG inoculation in pathogenic early days （≤3 days）. The morbidity of the skin on anal region and scrotum flushing and erosing in patients aged younger than 3 years was much higher than in patients aged older than 3 years. The morbidity of lymphadenenctasis in patients aged older than 3 years was much higher than in patients aged younger than 3 years. There were 52 cases involved in fever short of 5 days（100.0%）, 45 cases skin manifestation（86.5%）,40 cases lips reddened and rhagadiform（76.9% ）,39 cases bulbar conjunctiva hyperemic（75.0% ）,46 cases erythrocyte sedimentation accelerating （88.5%）, 44 cases leukocyte count adding（84.0%）, 42 cases C-reactive protein＇s amount increasing（80.8%）. In 3 cases cononary lesions occurred. In 6 cases D-dimer＇s amount increased during 5-7 days. In 40 cases（76.9%） specific diagnosis obtained during 7 days. Conclusion It was comparatively specific clinic manifestation in patients with KD that the tubercles of BCG inoculation became reddened and sclerotic and the skin on anal region and scrotum in patients aged younger than 3 years became flushing and erosing. The morbidity of lymphadenectasis in patients aged older than 3 years was much higer than patients aged younger 3 years. Fever,skin manifestation,reddened and rhagadiform lips, hyperemic bulbar conjunctiva, erythrocyte sedimentation accelerating, leukocyte count adding, C-reactive protein＇s amount increasing and D-dimer＇s amount increasing provided early diagnostic values. When highly doubted as KD in early days patients should complete echocardiographic study.
出处
《中国现代医生》
2008年第6期19-21,共3页
China Modern Doctor
关键词
川崎病
早期诊断
Kawasaki disease
Early diagnosis
