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目的分析川崎病器官损害的临床表现,提高KD的诊断水平。方法2000年1月-2007年10月首都儿科研究所附属儿童医院住院的202例KD患儿,行血、尿、粪常规、肝肾功能、胸部X线片、心电图、超声心动图、脑电图、脑脊液、肠道、呼吸道病毒等检测,并进行临床资料分析,总结KD器官损害的发生率。结果202例患儿中男137例,女65例;男女比例为2.11.0;年龄分布以婴幼儿为主,3岁以内(包括3岁)占71.3%。各器官受累情况:血液系统受累78例,占38.6%;呼吸系统受累76例,占37.6%;心血管系统受累68例,占33.7%;泌尿系统受累52例,占25.6%;消化系统受累23例,占11.4%;中枢神经系统受累3例,占1.5%;并败血症3例,幼年型类风湿关节炎、过敏性紫癜各1例。结论KD可累及全身多个器官,以血液系统受累率最高,并可同时并多个器官受累。KD临床表现多样,症状出现时间不一。临床医师不仅要掌握其典型的临床表现,对少见临床表现及器官损害也要有全面的认识。
Objective To analyze the clinical manifestations of organ damage in Kawasaki disease and to improve the diagnosis of KD. Methods From January 2000 to October 2007, 202 KD children hospitalized at the Children’s Hospital Affiliated to Capital Institute of Pediatrics were enrolled in this study. Blood, urine, fecal routine, liver and kidney function, chest X-ray, electrocardiogram, echocardiogram, Figure, cerebrospinal fluid, intestinal tract, respiratory virus detection, and clinical data analysis, summarize the incidence of KD organ damage. Results Of the 202 children, 137 were males and 65 were females. The male-female ratio was 2.11.0. The distribution of age was mainly infants and young children, 71.3% within 3 years (including 3 years). Each organ involved in the situation: the hematological involvement of 78 cases, accounting for 38.6%; respiratory involvement in 76 cases, accounting for 37.6%; cardiovascular system involvement in 68 cases, accounting for 33.7%; urinary system involvement in 52 cases, accounting for 25.6%; digestive system involvement 23 Cases, accounting for 11.4%; central nervous system involvement in 3 cases, accounting for 1.5%; and sepsis in 3 cases, juvenile rheumatoid arthritis, allergic purpura in 1 case. Conclusion KD can affect multiple organs of the whole body, with the highest rate of blood system involvement, and may involve multiple organs at the same time. KD clinical manifestations of diverse symptoms appear at different times. Clinicians should not only master the typical clinical manifestations, but also have a comprehensive understanding of the rare clinical manifestations and organ damage.