Bai Lihua, Feng Tienan, Yang Lifang, Zhang Yi, Jiang Xuejuan, Liao Jiayao, Chen Lihua, Feng Xiaoyan, Rong Yanming, Li Yuehua, Qin Zhiqiang, Qiao Jing
Department of Pediatrics, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University, Shanghai 200123, China.
Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Oncotarget. 2017 Apr 29;8(33):54357-54363. doi: 10.18632/oncotarget.17530. eCollection 2017 Aug 15.
In order to provide early intervention for coronary artery lesion (CAL) caused by Kawasaki Disease (KD), we analyzed clinical characteristics of typical and incomplete KD cases from 1998 to 2008 in Northwest and Central China. A total of 383 patients included 298 cases of typical KD and 85 cases of incomplete KD. The morbidity of incomplete KD was 28.5%, a percentage significantly lower than that of typical KD. The occurrence of bulbar conjunctiva congestion, erythra, crissum red, film-like decrustation, lip red, rhagades, raspberry tongue, bilateral toe-end decrustation, limb sclerosis, cervical lymph nodes enlargement, agitation and irritability in incomplete KD group was lower than that in the group of typical KD ( < 0.05); however, the occurrence of unilateral toe-end decrustation, scar reappearance erythema, malaise, fatigue, liver incidence was significant higher in incomplete KD group ( < 0.05). Based on lab assays and inspection index comparisons, the incomplete KD cases whose C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly increased, had significantly higher reduction in blood platelet (PLT). Interestingly, the KD patients with CPR higher than 30 mg/L, ESR higher than 40 mm/h, hepatomegaly and IVIG ineffectiveness, had higher incidence of CAL development. Altogether, our data have indicated differential clinical characteristics between incomplete KD and typical KD, and have identified several high risk factors of KD for CAL, such as hepatomegaly.
为了对川崎病(KD)所致冠状动脉病变(CAL)进行早期干预,我们分析了1998年至2008年华北和西北地区典型及不完全KD病例的临床特征。共有383例患者,其中典型KD 298例,不完全KD 85例。不完全KD的发病率为28.5%,明显低于典型KD。不完全KD组球结膜充血、皮疹、肛周红、膜状脱皮、唇红、皲裂、杨梅舌、双侧趾端脱皮、肢体硬肿、颈部淋巴结肿大、烦躁及易怒的发生率低于典型KD组(<0.05);然而,不完全KD组单侧趾端脱皮、瘢痕再现红斑、全身不适、乏力、肝脏受累的发生率明显较高(<0.05)。基于实验室检测和检查指标比较,C反应蛋白(CRP)和红细胞沉降率(ESR)显著升高的不完全KD病例,血小板(PLT)降低明显。有趣的是,CPR高于30 mg/L、ESR高于40 mm/h、肝肿大及静脉注射免疫球蛋白(IVIG)无效的KD患者,CAL发生风险较高。总之,我们的数据表明了不完全KD和典型KD之间的不同临床特征,并确定了KD发生CAL的几个高危因素,如肝肿大。