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[川崎病:三级医疗水平医院儿童的临床行为及心血管并发症]

[Kawasaki disease: clinical behaviour and cardiovascular complications in children in a tertiary-care level hospital].

作者信息

Gil Veloz Mariana, Flores Ruiz Eric M, Beirana Palencia Luisa G, Miranda Novales María Guadalupe, Huerta García Gloria C, Solórzano Santos Fortino

机构信息

Departamento de Pediatría Médica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.

出版信息

Arch Cardiol Mex. 2009 Jan-Mar;79(1):11-7.

Abstract

OBJECTIVES

To describe the clinical characteristics, outcome, and treatment response in a series of patients with Kawasaki disease (KD).

METHODS

Case-series, review of clinical records of children with KD diagnosis cared for from november 1999 to september 2006.

RESULTS

22 patients were included, male:female ratio, 1.4:1, 82% younger than 5 years, 14% with atypical presentation. Of the 22 patients, 10 (45%) received intravenous gammaglobulin (IVGG) in the first 10 days of symptoms onset at the recommended dose; four of them had coronary artery damage but none developed residual aneurysmatic lesions. Eight received IVGG in a different dose or after 10 days, six of them had coronary lesions and in two the damage was permanent. Four patients did not receive IVGG, and two had residual aneurysmatic lesions. None of those who received adequate treatment developed coronary residual damage, in comparison with 33% who received inadequate or no treatment, but difference was not statistically significant (P =.06).

CONCLUSIONS

KD is a rare clinical entity in our country; even though most of the cases occurred with classic clinical criteria, late referral and delay of treatment worsen the prognosis.

摘要

目的

描述一系列川崎病(KD)患者的临床特征、结局及治疗反应。

方法

病例系列研究,回顾1999年11月至2006年9月诊治的KD患儿临床记录。

结果

纳入22例患者,男女比例为1.4:1,82%年龄小于5岁,14%为非典型表现。22例患者中,10例(45%)在症状发作的前10天按推荐剂量接受静脉注射丙种球蛋白(IVGG)治疗;其中4例有冠状动脉损害,但均未形成残留动脉瘤样病变。8例接受不同剂量IVGG治疗或在症状发作10天后接受治疗,其中6例有冠状动脉病变,2例损害为永久性。4例患者未接受IVGG治疗,2例有残留动脉瘤样病变。接受充分治疗者均未出现冠状动脉残留损害,而接受不充分治疗或未治疗者中这一比例为33%,但差异无统计学意义(P = 0.06)。

结论

KD在我国是一种罕见的临床疾病;尽管大多数病例符合经典临床标准,但就诊延迟和治疗延误使预后恶化。

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