Tizard E J, Suzuki A, Levin M, Dillon M J
Department of General Paediatrics and Nephrology, Hospital for Sick Children, London.
Arch Dis Child. 1991 Feb;66(2):185-8. doi: 10.1136/adc.66.2.185.
We report 101 episodes of Kawasaki disease in 100 patients seen over a 12 year period. A total of 35 patients had cardiac involvement ranging from pericardial effusion to coronary artery aneurysms with ischaemic complications, which resulted in death in one patient. Laboratory investigations showed leucocytosis, thrombocytosis, and a raised erythrocyte sedimentation rate to be common features and the first two variables were significantly associated with cardiac involvement. Treatment regimens changed over the study period. Aspirin was used in most patients often in conjunction with dipyridamole and from 1986 intravenous immunoglobulin was given routinely to those patients seen early in the illness. Additional therapeutic measures in individual patients included prostacyclin, heparin, streptokinase, and plasma exchange/exchange transfusion. Attention is drawn to the uncertainity of the long term cardiovascular consequences in the light of adults reported with premature atherosclerotic lesions of similar appearance to those seen in Kawasaki disease.
我们报告了在12年期间诊治的100例患者中发生的101次川崎病发作。共有35例患者出现心脏受累,范围从心包积液到冠状动脉瘤并伴有缺血性并发症,其中1例患者死亡。实验室检查显示白细胞增多、血小板增多和红细胞沉降率升高是常见特征,前两个变量与心脏受累显著相关。在研究期间治疗方案有所改变。大多数患者使用阿司匹林,通常与双嘧达莫联合使用,从1986年起,对疾病早期就诊的患者常规给予静脉注射免疫球蛋白。个别患者的其他治疗措施包括前列环素、肝素、链激酶以及血浆置换/换血输血。鉴于有报道称成年人出现与川崎病所见类似外观的过早动脉粥样硬化病变,需注意长期心血管后果的不确定性。