小儿典型川崎病与不完全性川崎病的临床特征分析

闵晓兰　卢玉容　蔡强

摘 要：目的 探討小儿典型川崎病与不完全性川崎病的临床特征。方法 研究选取2012年1月～2017年1月宜宾市第二人民医院接收的76例小儿川崎病患儿为观察对象，按照入院顺序分为两组，每组38例，A组为典型川崎病患儿，B组为不完全性川崎病患儿，比较两组患儿的临床症状，实验室检查指标特征。结果 两组患儿的发热、指端脱屑、肛周脱屑等症状发生率比较，差异无统计学意义（P>0.05），两组患儿的血钠、Hb、ALB、ESR、ALT、PLT计数对比，差异无统计学意义（P>0.05），A、B组皮疹（71.1%vs28.9%）、手足水肿（78.95%vs39.47%）、卡巴红肿（13.16%vs34.21%）、球结膜充血（92.10%vs34.21%）、口腔黏膜充血（86.84%vs52.63%）、颈部淋巴结肿大发生率（73.68%vs50.00%）比较，差异有统计学意义（P<0.05）。A组发热持续时间（9.4±0.3）d，高于B组（7.9±0.4）d；A、B两组的CRP、WBC指标则分别为[（34.3±21.4）mg/L vs（51.7±33.6）mg/L]和[（14.8±6.4）×109/L vs（19.6±5.7）×109/L]，差异有统计学意义（P<0.05）。结论 相比于典型川崎病患儿，不完全性川崎病患儿发生皮疹、卡巴红肿、手足水肿、口腔黏膜充血等症状的几率更低，且其发热症状持续时间更短，CRP水平与WBC计数更高。

关键词：典型川崎病；不完全性川崎病；临床特征

中图分类号：R725.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.054

文章编号：1006-1959（2018）10-0156-03

Clinical Features of Typical Mucocutaneous Lymph Node Syndrome and Incomplete Mucocutaneous Lymph Node Syndrome

MIN Xiao-lan，LU Yu-rong，CAI Qiang

（Department of Pediatrics，Yibin Second People's Hospital，Yibin 644000，Sichuan，China）

Abstract：Objective To investigate the clinical features of typical mucocutaneous lymph node syndrome and incomplete mucocutaneous lymph node syndrome in children.Methods The study selected 76 cases of children with mucocutaneous lymph node syndrome in the Second People's Hospital of Yibin City from January 2012 to January 2017 as the subjects of observation.According to the order of admission，the patients were divided into two groups，38 cases in each group.Group A was typical mucocutaneous lymph node syndrome patients.Children in group B were children with incomplete mucocutaneous lymph node syndrome.The clinical symptoms and characteristics of laboratory tests were compared between the two groups.Results There was no significant difference in the incidence of fever，finger desquamation，and perianal scaling between the two groups （P>0.05）.There was no significant difference in serum sodium，Hb，ALB，ESR，ALT and PLT counts between the two groups（P>0.05）.The rashes in group A and B（71.1% vs28.9%），Hand-foot edema（78.95%vs.39.47%），Kappa redness（13.16%vs.34.21%），conjunctival hyperemia（92.10%vs.34.21%），oral mucosal hyperemia（86.84%vs.52.63%），the incidence of lymph node enlargement in the neck（73.68%vs50.00%）was statistically significant （P<0.05）.The duration of fever in group A was（9.4±0.3）d，which was higher than that in group B（7.9±0.4）d.The indexes of CRP and WBC in groups A and B were[（34.3±21.4）mg/L vs（51.7±33.6）]mg/L]and[（14.8±6.4）×109/L vs（19.6±5.7）×109/L]，the difference was statistically significant（P<0.05）.Conclusion Compared with children with typical mucocutaneous lymph node syndrome，children with incomplete mucocutaneous lymph node syndrome have lower incidences of rash，kabah red swelling，hand-foot edema，and oral mucosal hyperemia，and the duration of fever symptoms is shorter.CRP level and WBC count higher.

Key words：Typical mucocutaneous lymph node syndrome；Incomplete mucocutaneous lymph node syndrome；Clinical features

小儿皮肤黏膜淋巴结综合征（mucocutaneous lymph node syndrome，MCLS）又称川崎病，作为临床上患病率较低的急性全身性血管炎性疾病，在婴幼儿中的发病几率普遍较高。随着川崎病发病机制的研究不断深入，不完全性川崎病发病率的逐渐增多，而川崎病又存在规律性差、发病早期的临床症状不明显等特点，易出现漏诊与误诊率较高的情况[1]。因此，为了提升临床上对于不完全性川崎病的认知水平，进一步明确小儿典型川崎病与不完全性川崎病的临床特征差异[2]，本研究选取不完全性川崎病患儿与典型川崎病患儿为观察对象，分析、比较不同组别患儿的临床症状发生状况与实验室检查结果，探讨典型川崎病患儿与不完全性川崎病患儿的临床特征，现做如下报道。