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目的总结川崎病(KD)和传染性单核细胞增多症(IM)的临床特点,探讨二者临床表现、实验室检查结果 ,分析疾病早期误诊、漏诊原因。方法回顾性分析本院2010年10月~2013年7月间收治的55例川崎病患儿、112例传染性单核细胞增多症患儿的临床资料。结果 55例川崎病患者中,46例早期确诊,9例延迟确诊,早期误诊率约16.4%。112例传染性单核细胞增多症患者中,74例早期确诊,38例延迟确诊,早期误诊率约34.0%。KD与IM各自的早期确诊组与延迟确诊组相比,在症状体征和实验室检查方面,差异有统计学意义(P<0.05)。结论川崎病和传染性单核细胞增多症早期症状不典型,常累及其他系统,确诊难度大。因二者均有引起严重并发症的可能,因此,提高对疾病的认识,动态监测患者各实验室指标是避免误诊的关键。
Objective To summarize the clinical characteristics of Kawasaki disease (KD) and infectious mononucleosis (IM), discuss the clinical manifestations and laboratory findings of both, and analyze the causes of early misdiagnosis and missed diagnosis. Methods The clinical data of 55 cases of Kawasaki disease and 112 cases of infectious mononucleosis in our hospital from October 2010 to July 2013 were retrospectively analyzed. Results Among the 55 Kawasaki disease patients, 46 cases were diagnosed early and 9 cases were delayed. The early misdiagnosis rate was 16.4%. In 112 cases of infectious mononucleosis patients, 74 cases were diagnosed early and 38 cases were delayed diagnosed. The early misdiagnosis rate was 34.0%. The differences between the early diagnosis group and the late diagnosis group of KD and IM were statistically significant (P <0.05) in the aspects of symptoms and signs and laboratory tests. Conclusion Kawasaki disease and infectious mononucleosis syndrome are not typical early symptoms, often involving other systems, diagnosis is difficult. Because both have the possibility of causing serious complications, therefore, to improve awareness of the disease, the dynamic monitoring of the patient’s laboratory indicators is to avoid misdiagnosis of the key.