摘要目的:通过对比分析川崎病肠道受累(intestinal involvement in Kawasaki disease，IIKD)与腹型紫癜(abdominal type allergic purpura，ATAP)的超声图像，提高对IIKD的认识。方法:收集2014年7月至2020年1月在天津市儿童医院就诊、经临床诊断为川崎病(Kawasaki disease，KD)且腹部超声有阳性发现的21例KD患儿(IIKD组)及24例经临床诊断为ATAP患儿(ATAP组)的超声图像，并进行对比分析。结果:单因素分析显示，IIKD组与ATAP组在肠壁非分层增厚、浆膜和相邻肠系膜回声减低(形态不规则)、周围脂肪组织增厚及相邻淋巴结形态异常方面差异有统计学意义(均 P<0.05)；多因素分析显示，浆膜和相邻肠系膜回声减低(形态不规则)为IIKD的独立影响因素，ROC曲线下面积为0.914(95% CI＝0.819～1.000， P<0.001)，其诊断IIKD的敏感性和特异性分别为95.2%、87.5%。 结论:IIKD和ATAP的超声图像具有一定的特异性，浆膜和相邻肠系膜回声减低(形态不规则)可有效鉴别二者。

abstractsObjective:To compare and analyze the ultrasonic images between intestinal involvement in Kawasaki disease (IIKD) and abdominal type allergic purpura (ATAP), so as to improve the understanding of IIKD.Methods:From July 2014 to January 2020, the ultrasonographic images of 21 children with IIKD and 24 children with ATAP in Tianjin Children′s Hospital were collected and analyzed.Results:Univariate analysis showed that there were significant differences between IIKD group and ATAP group in non stratified thickening of intestinal wall, decreased echo of serosa and adjacent mesentery (irregular shape), thickening of peripheral fat tissue and abnormal shape of adjacent lymph nodes (all P<0.05); Multivariate analysis showed that decreased echo of serosa and adjacent mesentery (irregular shape) were independent influencing factors of IIKD. The area under ROC curve was 0.914(95% CI=0.819-1.000, P<0.001). The sensitivity and specificity of IIKD were 95.2% and 87.5%, respectively. Conclusions:The ultrasonographic images of intestinal involvement in IIKD and ATAP have certain specificity. Decreased echo of serosa and adjacent mesentery (irregular shape) can effectively distinguish IIKD and ATAP.