中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2012年
4期
364-366
,共3页
川崎病%冠状动脉疾病%小儿
川崎病%冠狀動脈疾病%小兒
천기병%관상동맥질병%소인
Kawasaki disease%coronary artery disease%children
目的 探讨川崎病(KD)患儿的临床表现、诊断及治疗方案.方法 选择2007年9月至2010年6月本院收治并诊断为KD,且常规接受口服阿司匹林治疗的36例患儿的临床病历资料为研究对象.其年龄为2个月～6岁.采用回顾性分析法,对KD患儿临床病历资料中的临床症状及治疗方案进行相关分析.按照静脉输注丙种球蛋白(intravenous immunoglobulin,IVIG)治疗剂量不同,将36例KD患儿分为A组[n=8,0.4 g/(kg·d)×3 d],B组[n=20,1 g/(kg·d)×2 d]和C组[n=8,2 g/(kg·d)×1 d].3组患儿的KD初诊年龄、病情严重程度及相关并发症发生情况等比较,差异无统计学意义(P＞0.05)(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,征得患儿监护人的知情同意,并签署知情同意书).结果 本组KD患儿最常见的临床表现为发热,口腔黏膜及咽部弥漫性充血,口、唇潮红及皲裂等,并且均为KD最早期症状;实验室检查表现为C反应蛋白(CRP)异常升高、白细胞计数升高及血沉增快等早期表现.不同IVIG剂量组的退热时间比较,B组、C组分别与A组比较,差异有统计学意义(P＜0.05);但B组与C组比较,差异无统计学意义(P＞0.05).结论 KD的治疗重点为极早控制血管炎,防止形成冠状动脉瘤(CAA)等.对诊断为KD患儿采用IVIG[(1～2)g/(kg·d)×(1～2)d]治疗,具有更强退热效果.
目的 探討川崎病(KD)患兒的臨床錶現、診斷及治療方案.方法 選擇2007年9月至2010年6月本院收治併診斷為KD,且常規接受口服阿司匹林治療的36例患兒的臨床病歷資料為研究對象.其年齡為2箇月～6歲.採用迴顧性分析法,對KD患兒臨床病歷資料中的臨床癥狀及治療方案進行相關分析.按照靜脈輸註丙種毬蛋白(intravenous immunoglobulin,IVIG)治療劑量不同,將36例KD患兒分為A組[n=8,0.4 g/(kg·d)×3 d],B組[n=20,1 g/(kg·d)×2 d]和C組[n=8,2 g/(kg·d)×1 d].3組患兒的KD初診年齡、病情嚴重程度及相關併髮癥髮生情況等比較,差異無統計學意義(P＞0.05)(本研究遵循的程序符閤本院人體試驗委員會製定的倫理學標準,得到該委員會批準,徵得患兒鑑護人的知情同意,併籤署知情同意書).結果 本組KD患兒最常見的臨床錶現為髮熱,口腔黏膜及嚥部瀰漫性充血,口、脣潮紅及皸裂等,併且均為KD最早期癥狀;實驗室檢查錶現為C反應蛋白(CRP)異常升高、白細胞計數升高及血沉增快等早期錶現.不同IVIG劑量組的退熱時間比較,B組、C組分彆與A組比較,差異有統計學意義(P＜0.05);但B組與C組比較,差異無統計學意義(P＞0.05).結論 KD的治療重點為極早控製血管炎,防止形成冠狀動脈瘤(CAA)等.對診斷為KD患兒採用IVIG[(1～2)g/(kg·d)×(1～2)d]治療,具有更彊退熱效果.
목적 탐토천기병(KD)환인적림상표현、진단급치료방안.방법 선택2007년9월지2010년6월본원수치병진단위KD,차상규접수구복아사필림치료적36례환인적림상병력자료위연구대상.기년령위2개월～6세.채용회고성분석법,대KD환인림상병력자료중적림상증상급치료방안진행상관분석.안조정맥수주병충구단백(intravenous immunoglobulin,IVIG)치료제량불동,장36례KD환인분위A조[n=8,0.4 g/(kg·d)×3 d],B조[n=20,1 g/(kg·d)×2 d]화C조[n=8,2 g/(kg·d)×1 d].3조환인적KD초진년령、병정엄중정도급상관병발증발생정황등비교,차이무통계학의의(P＞0.05)(본연구준순적정서부합본원인체시험위원회제정적윤리학표준,득도해위원회비준,정득환인감호인적지정동의,병첨서지정동의서).결과 본조KD환인최상견적림상표현위발열,구강점막급인부미만성충혈,구、진조홍급군렬등,병차균위KD최조기증상;실험실검사표현위C반응단백(CRP)이상승고、백세포계수승고급혈침증쾌등조기표현.불동IVIG제량조적퇴열시간비교,B조、C조분별여A조비교,차이유통계학의의(P＜0.05);단B조여C조비교,차이무통계학의의(P＞0.05).결론 KD적치료중점위겁조공제혈관염,방지형성관상동맥류(CAA)등.대진단위KD환인채용IVIG[(1～2)g/(kg·d)×(1～2)d]치료,구유경강퇴열효과.
Objective To analyze clinical manifestations,diagnosis and treatment measures of 36 children with Kawasaki disease (KD).Methods From September 2007 to June 2010,a total of 36 children with KD,at the age from 2-month-old to six-year-old,were admitted to our hospital.We retrospectively reviewed the clinical data of the 36 children with KD,summarized data of clinical manifestations and treatment measures. They were divided into three groups according to different dose of intravenous immunoglobulin (IVIG),group A [n=8,0.4 g/(kg · d)× 3 d],group B [n=20,1 g/(kg · d)× 2 d] and group C [n=8,2 g/(kg · d) × 1 d].There had no significant difference among three groups on ages,severity of the diseases,and related complications (P＞0.05).This study followed procedures with the committee for human trials of the ethical standards,get the commission for approval,group the consent of the subjects of the guardian informed consent,and its clinical research informed agreement signed.Results Fever,hyperaemia of oral and pharynx mucosal,and chap of lips mucosal were the most common signs of KD children. Abnormal rise of C-reactive protein (CRP) level, white cell count and erythrocyte sedimentation rate (ESR) were the most common abnormalities of laboratory test in the early course.There were significant differences between group A and group B,group A and group C (P＜0.05),but there had no significant difference between group B and group C (P＞0.05).Conclusions Early control of vasculitis are very important to KD,in order to prevent the formation of coronary artery aneurysms (CAA).The IVIG dose at (l～2)g/(kg · d) has more powerful antifebrile efficacy.
