Hu Xiao-hong, Xu Shi-xia, Luan Zuo
Department of Pediatrics, General Hospital of the Navy, Beijing 100037, China.
Di Yi Jun Yi Da Xue Xue Bao. 2003 Aug;23(8):853-5.
To explore the possibility of early diagnosis of Kawasaki disease (KD) complicated by coronary artery lesions (CAL).
Medical records of 84 children with KD (2 months to 8 years of age) were reviewed retrospectively. Diagnosis of KD was based on current diagnostic criteria of KD. Laboratory examinations were performed for white blood cells (WBC), hemoglobin (HB), platelet counts (Plt), and C-reactive protein (CRP), along with electrocardiography (ECG) and echocardiography within 7 days after the onset of the disease. The Pearson correlation and multivariate analysis (logistic) were used for statistical analysis.
During the first 7 days, clinical manifestations of the patients included fever (100%), conjunctivitis (71.46%), skin rash (66.7%), extremity change (54%), oral mucosa change (80%), and cervical lymphadenopathy (25%). Laboratory examinations revealed elevated WBC, CRP, and ECG (P<0.05, 0.05,0.01, respectively) in patients with CAL. Multivariate logistic regression analysis indicated that ECG positivity (P<0.01) and WBC increases (P<0.01) were independently correlated with CALs in acute KD.
CRP (+), ECG (+), WBC count increase during the acute phase of KD are important indicators to predict CAL caused by KD.
探讨川崎病（KD）并发冠状动脉病变（CAL）早期诊断的可能性。
回顾性分析84例年龄在2个月至8岁的KD患儿的病历资料。KD的诊断依据现行KD诊断标准。在疾病发作后7天内进行白细胞（WBC）、血红蛋白（HB）、血小板计数（Plt）和C反应蛋白（CRP）的实验室检查，以及心电图（ECG）和超声心动图检查。采用Pearson相关性分析和多因素分析（逻辑回归）进行统计学分析。
在最初7天内，患者的临床表现包括发热（100%）、结膜炎（71.46%）、皮疹（66.7%）、四肢变化（54%）、口腔黏膜变化（80%）和颈部淋巴结肿大（25%）。实验室检查显示CAL患者的WBC、CRP升高以及心电图异常（分别为P<0.05、0.05、0.01）。多因素逻辑回归分析表明，心电图阳性（P<0.01）和WBC升高（P<0.01）与急性KD中的CAL独立相关。
KD急性期CRP（+）、ECG（+）、WBC计数升高是预测KD所致CAL的重要指标。
