| Objective:Kawasaki disease(KD)has passed more than half a century since it had been first reported by the Japanese scholar Kawasaki rich in 1967.It has been reported around the world,with higher incidence in Asia.The incidence of Kawasaki disease in our country has also increased in recent years.Its self-limited disease,most of it is curable.But there are still some patients combining some complications such as cardiovascular disease.This study is to explore and summarize clinical and laboratory data of different age groups of children with Kawasaki disease,further strengthen clinicians understanding of children with KD for improving the level of diagnosis and treatment of KD and reducing the complications of Kawasaki disease.Methods:The Clinical materials of 133 cases hospitalized in department of Respiratory,Children’s Hospital of Hebei province were retrospectively analyzed.The age range of children is one month 25 days to 6 years old According to the age,the children were allocated into infant group(less than one year old),young children group(1 to 3 years old)and preschool children group(>3 to 6 years old).The main clinical manifestation(fever,rash,eye combined with membrane hyperemia,oral congestion or lips cracking,arbutus tongue,neck lymph node enlargement,the brotherhood or hard swollen of lupus,the desquamate of fingertips or toes,theflush or peeling of anus periderm skin),laboratory examination(WBC,NE%,HGB,PLT,CRP,ESR,ALT,LDH),echocardiographic manifestations(CAL,pericardial effusion,heart valve regurgitation)and the response of treatment with intravenous immuno globulin(IVIG)and the prevalence of IKD of three groups were compared.Results:1 Main clinical manifestations1.1 There were no statistical differences of three groups about fever,rash,eye combined with membrane hyperemia,oral congestion or lips cracking,the brotherhood or hardswollenof lupus,the desquamate of fingertipsor toes,the flushor peeling of anus periderm skin(P>0.05).There were respectively 6 cases(100%),57cases(100%),30cases(100%)with fever in infant group,young children group and preschool children group.There were respectively 30cases(65.2%),26cases(45.6%),14cases(46.7%)with rash.There were respectively 32cases(69.6%),45cases(78.9%),27cases(90.0%)with eye combined with membrane hyperemia.There were respectively 29cases(63.0%),45cases(78.9%),20cases(66.7%)with oral congestion or lips cracking.There were respectively 17cases(37.0%),28cases(49.1%),14cases(46.7%)with the brotherhood or hardswollenof lupus.There were respectively 18cases(39.1%),21cases(36.8%),7cases(23.3%)with the desquamate of fingertips or toes.There were respectively 13cases(28.3%),26cases(45.6%),10cases(33.3%)with the flushor peeling of anus periderm skin.1.2 There were statistical differences of three groups on arbutus tongue,neck lymph node enlargement,IKD(P<0.05).The incidence of arbutus tongue of infant group,young children group and preschool children group was respectively 60.9%(28cases),64.9%(37cases),33.3%(10cases).The incidence of neck lymphnode enlargement of three groups was respectively 28.3%(13cases),54.4%(31cases),86.7%(26cases).The incidence of IKD of three groups was respectively 71.7%(33cases),45.6%(26cases),36.7%(11cases).The incidence of arbutus tongue of infant group was significantly higher than that of the young children and preschool children group.The incidence of neck lymph node enlargement.As the age was growing,the risk of neck lymph node enlargement was increased.The incidence of incomplete Kawasaki disease of infant group was higher than that of the young children and preschool children group(all P<0.05).2 The laboratory examination2.1 The WBC,PLT,CRP,ESR,ALT of three groups were no statistical differences(P>0.05).The WBC of infant group,young children group and preschool children group was respectively [14.60(12.48,20.03)109/L],[16.70(12.45,22.29)×109/L],[18.90(13.60,23.75)×109/L].The PLT of three groups was respectively[399.00(312.00,490.00)×109/L],[373.00(314.00,504.00)× 109/L],[345.00(279.00,400.00)×109/L].The CRP of three groups was respectively[68.00(35.30,102.00)mg/L],[65.00(35.00,100.00)mg/L],[84.50(40.00,114.30)mg/L].The ESR of three groups was respectively[50.00(36.75,53.25)mm/h],[45.00(34.00,51.00)mm/h],[43.50(30.00,50.00)mm/h].The ALT of three groups was respectively[23.00(17.75,36.35)U/L],[22.00(12.50,51.50)U/L],[15.50(8.00,46.00)U/L].2.2 The three groups had statistical differences on NE%,HGB,LDH(P<0.05).The NE% of three groups was respectively [55.35(47.45,68.78)%],[63.50(51.40,76.60)%],[78.85(72.03,89.05)%].The HGB of three groups was respectively[102.50(95.00,109.50)g/L],[113.00(104.00,119.00)g/ L],[ 119.00(111.00,125.00)g/L].The LDH of three groups was respectively[244.50(205.00,272.30)U/L],[246.00(220.00,269.00)U/L],[209.00(182.50,242.00)U/L].The NE% of preschoolchildren was significantly higher than of infants and young children group.The smaller was the age,the lower was HGB.The LDH of infants and young children group was higher than of preschool children(P<0.05).3 Echocardiographic manifestations: The children with CAL of infant group,young children group and preschool children group were respectively 14cases(30.4%),7cases(12.3%),5cases(16.7%).The children with pericardial effusion of three groups were respectively 1cases(2.2%),3cases(5.3%),1cases(3.3%).The children with heart valve regurgitation were respectively 2cases(4.3%),7cases(12.3%),1cases(3.3%).The cardiacultrasound performance of three groups were nostatistical differences(P>0.05).4 Treatment: There were 40cases(87.0%)in infant group and 51cases(89.5%)in young children group,28cases(93.3%)in preschool childrenwho had response to treatment with IVIG.The three groups had no statistical differences in the response of treatment with IVIG(P>0.05).Conclusions:1 The clinical manifestations:The incidence of arbutus tongue of infants and young children with KD is higher than preschool children with KD,we should pay attention to check its oral artifact.The incidence of neck lymph node enlargement of children with KD is gradually increasing.The incidence of IKD of infants with KD is higher than young children and preschool children with KD,we should avoid missed diagnosis for small babies.2 The aboratory examination:The increased degree of NE% of preschool children with KD is higher than infants and young children.The smaller of age,the higher risk of anemia within 6 years old children with KD.The increased degree of LDH of infants and young children with KD is higher than preschool children,they are more prone to tissue damage.3 Echocardiographic manifestations: The KD patients within 6 yearsold all can present CAL,pericardial effusion,heart valve regurgitation.It has not significant correlation with age.4 Treatment: The response of IVIG therapy of children with KD has no obvious difference with age. |
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