浙江中医药大学学报
浙江中醫藥大學學報
절강중의약대학학보
JOURNAL OF ZHEJIANG UNIVERSITY OF TRADITIONAL CHINESE MEDICINE
2014年
4期
419-421,422
,共4页
KD%年龄%冠状动脉损害%炎症因子%丙种球蛋白%临床特点
KD%年齡%冠狀動脈損害%炎癥因子%丙種毬蛋白%臨床特點
KD%년령%관상동맥손해%염증인자%병충구단백%림상특점
KD%age%coronary arterial disease%inflammtory factors%gamma globin%clinical characteristics
[目的]对大年龄组(5岁以上)和低年龄组儿童(5岁以下)川崎病(kawasaki disease,KD)患儿的临床特点进行比较分析,以进一步提高对大年龄组儿童KD临床表现的认识。[方法]对2004年1月至2011年5月在浙江省台州地区诊治的KD患儿资料进行回顾性分析和总结。[结果]158例KD患儿中低年龄组共119例(75.3%),大年龄组共39例(24.7%)。研究发现,大年龄组儿童较低年龄组儿童皮疹发生率低(P<0.01);在使用丙种球蛋白前后,大年龄组儿童发热持续时间均较低年龄组儿童长,且冠状动脉病变及不完全KD的发生率较高。但两组之间丙种球蛋白治疗有效性、结膜充血、手足硬肿、淋巴结肿大、脱皮等发生率无统计学差异(P>0.05)。实验室检查发现大年龄组比低年龄组的血沉、血红蛋白及白细胞明显升高(P<0.05),并且与低年龄组比较,大年龄组急性期有炎症因子的高表达。[结论]大年龄组儿童不完全KD和冠状动脉病变发生率均较高,其较高的冠状动脉病变发生率可能与剧烈的炎症反应有关。
[目的]對大年齡組(5歲以上)和低年齡組兒童(5歲以下)川崎病(kawasaki disease,KD)患兒的臨床特點進行比較分析,以進一步提高對大年齡組兒童KD臨床錶現的認識。[方法]對2004年1月至2011年5月在浙江省檯州地區診治的KD患兒資料進行迴顧性分析和總結。[結果]158例KD患兒中低年齡組共119例(75.3%),大年齡組共39例(24.7%)。研究髮現,大年齡組兒童較低年齡組兒童皮疹髮生率低(P<0.01);在使用丙種毬蛋白前後,大年齡組兒童髮熱持續時間均較低年齡組兒童長,且冠狀動脈病變及不完全KD的髮生率較高。但兩組之間丙種毬蛋白治療有效性、結膜充血、手足硬腫、淋巴結腫大、脫皮等髮生率無統計學差異(P>0.05)。實驗室檢查髮現大年齡組比低年齡組的血沉、血紅蛋白及白細胞明顯升高(P<0.05),併且與低年齡組比較,大年齡組急性期有炎癥因子的高錶達。[結論]大年齡組兒童不完全KD和冠狀動脈病變髮生率均較高,其較高的冠狀動脈病變髮生率可能與劇烈的炎癥反應有關。
[목적]대대년령조(5세이상)화저년령조인동(5세이하)천기병(kawasaki disease,KD)환인적림상특점진행비교분석,이진일보제고대대년령조인동KD림상표현적인식。[방법]대2004년1월지2011년5월재절강성태주지구진치적KD환인자료진행회고성분석화총결。[결과]158례KD환인중저년령조공119례(75.3%),대년령조공39례(24.7%)。연구발현,대년령조인동교저년령조인동피진발생솔저(P<0.01);재사용병충구단백전후,대년령조인동발열지속시간균교저년령조인동장,차관상동맥병변급불완전KD적발생솔교고。단량조지간병충구단백치료유효성、결막충혈、수족경종、림파결종대、탈피등발생솔무통계학차이(P>0.05)。실험실검사발현대년령조비저년령조적혈침、혈홍단백급백세포명현승고(P<0.05),병차여저년령조비교,대년령조급성기유염증인자적고표체。[결론]대년령조인동불완전KD화관상동맥병변발생솔균교고,기교고적관상동맥병변발생솔가능여극렬적염증반응유관。
[Objectives] To evaluate characteristics of Kawasaki disease(KD) in children younger than 5 years old in comparison with older than 5 years old, and to improve the knowledge of clinicians on KD in older children. [Method] The clinical characteristics and treatment of Kawasaki disease from January, 2004 to May,2011 were analyzed retrospectively and summarized .[Results] A total of 158 patients were included in this study, 39 patients(24.7%) were ≥5 years old and 79 patients(75.3%) were<5 years old. The older children seemed to have longer total fever duration, pre-intravenous immunoglobulin(IVIG) and post-IVIG fever duration and higher coronary artery disease(23.08% vs.8.40%) than the younger children, and the incidence rate of incomplete KD was higher in younger infant. But there was no difference in effect of IVIG ,incidence of conjunctival hyperemia, extremity hardness, cervical lymphadenopathy and rash, etc(P>0.05). There was statistical difference in erythrocyte sedimentation rate(ESR), hemoglobin(Hb) and white blood cell(WBC) count between 2 groups(P<0.05).The expression of inflammation factor in acute phase of older children was higher than the younger children(P<0.05). [Conclusions] Older patients had a higher prevalence of KD and coronary artery abnormalities than the younger patients. The occurrence of coronary artery might be related to more marked inflammatory response.