关键词: 川崎病, 冠状动脉损害, 静脉注射用丙种球蛋白, 关节病变

Abstract: Objective:To explore the clinical characteristics of the Kawasaki disease children with joint involvement,and to determine whether joint involvement will affect the coronary artery damage rate, intravenous immunoglobulin (IVIG) reactivity and prognosis in the children with Kawasaki disease. Methods:A total of 636 cases of children with Kawasaki disease with clear diagnosis and complete informations were selected.According to whether there were the local symptoms of the joints or not,they were divided into joint involvement group(n=31) and non-joint involvement group(n=605).The clinical and auxiliary examination data of the Kawasaki disease children were retrospectively analyzed.The clinical features,laboratory indexes,coronary artery damage rate and IVIG response rate of the children were compared between joint involvement group and non-joint involvement group. Results:Among 31 Kawasaki disease child patients with joint involvement,there were 25 cases(80.6%)of children more than 3 years old,26 cases(83.9%)) diagnosed with complete Kawasaki disease,24 cases(77.4%) of multiple joint involvement (≥ 2 joints),26 cases(83.9%) of big joint involvement,and the knee joint involvement was more common (20 cases,64.5%).The duration of joint local symptoms varied,and no local joint sequelae occurred after follow-up.The fever time of the children in joint involvement group was longer than that in non-joint involvement group,and the difference was statistically significant(P<0.05).The number of WBC,neutrophil percentage and C-reactive protein level of the children in joint involvement group were higher than those in non-joint involvement group,and the difference was statistically significant(P<0.05).There was no significant difference in coronary vascular damage rate between two groups(P>0.05).The IVIG non-response rate of the children in joint involvement group was higher than that in non-joint involvement group(39.3% vs 10.9%),and the difference was statistically significant(P<0.05). Conclusion:Kawasaki disease with joint involvement mostly occurs in the children over 3 years old.When Kawasaki disease accompanies with joint involvement,it tends to multiple joint involvement(≥ 2 joints),more common in the big joint,especially in knee joint involvement. Kawasaki disease accompanying with joint involvement has no affect on the incidence of coronary artery lesions,but it behaves poor reactivity to IVIG.Joint involvement is a transient symptom of Kawasaki disease,and there are no sequelae occurred.

Key words: joint lesion, coronary artery lesion, Kawasaki disease, intravenous immunoglobulin