| Objective: To investigate the severity of coronary artery lesions in children with Kawasaki disease and the clinical value of predicting the prognosis by using Z-score of the diameter of coronary artery in echocardiography.Methods: The cases of 218 children which were diagnosed as kawasaki disease and received,cured by Hunan Children’s Hospital from December 2016 to June 2017 were reviewed and analyzed;ultrasonic cardiograms of the children with kawasaki disease at the acute stage and the restoration stage were collected;the coronary artery diameters of them were measured and the Z-score of the coronary artery diameter was calculated according to the formula;the general information of children patient(height,weight,age)was registered;the related clinical manifestation of child patients at the acute stage and restoration stage(typical and atypical kawasaki disease appearance)and the result of related biochemical test(c-reactive protein,blood platelet count,white blood cell count,erythrocyte sedimentation rate)were recorded.Then divided them into five groups according to the Z-core of the coronary artery diameter,including the group without dilatation of coronary artery: Z <2,group with dilatation of coronary artery 2 ≤Z<2.5,group with small coronary artery aneurysm: Z <5,group with medium coronary artery aneurysm: 5≤Z<10,group with large coronary artery aneurysm: Z ≥10,and the stepped variation and correlation related to gender,age,clinical manifestation,fever time,results of laboratory examination,coronary artery diameter and Z-score among the children with kawasaki disease in each group were researched.Result: There was no statistical significance in the comparing difference related to age,gender and clinical manifestations among the five groups(P> 0.05).The fever duration of children with kawasaki disease in five groups respectively were shown as follows: the group without dilatation of coronary artery:(6.50±1.37)days,the group with dilatation of coronary artery:(8.01 + 1.41)days,and the rest three groups:(10.50±1.87)days,(12.01±1.89)days and(15.33±2.80)days,whose difference had statistical significance(F = 18.02,P = 18.02).In addition that there was no statistical significance in the comparison between the group without dilatation of coronary artery or the group with dilatation of coronary artery,and there was statistical significance in the comparison among the rest groups;the changes in the fever duration had significant correlation with the changes in the Z-score of coronary artery(R2=0.76).There was statistical significance in comparing difference of C-reactive protein and blood platelet count of the children with kawasaki disease in each group at the acute stage(P < 0.05);among all of them,there was statistical significance in comparing difference of the CRP between the group with large coronary artery aneurysm and the rest groups at the acute stage(P < 0.05).But the change of CRP at the acute stage had no significant linear correlation with the Z-score of coronary aneurysm(R2=0.04;P=0.81).There was statistical significance in the comparing difference of PLT among five groups at the acute stage(P < 0.05),and the platelet counts of children with kawasaki disease at the acute stage increase with the Z-score of coronary artery.Besides,the change of platelet count of each child with kawasaki disease at the acute phase had significant linear correlation with the Z-score of coronary artery(R2=0.73;P<0.05).There was no statistical significance in the comparing difference of ESP and WBC among the five groups(P>0.05).There was no statistical significance in comparing difference of ESP and WBC among the children with kawasaki disease in five groups,but there was significant difference in Z-score of the group without dilatation of coronary artery(P < 0.05),and there was no statistical significance in comparing difference of Z-core and coronary artery diameter in the group with dilatation of coronary artery,the group with small coronary artery aneurysm,the group with medium coronary artery aneurysm and the group with large coronary aneurysm.Conclusion: 1)The Z-score ration of coronary artery of children with kawasaki disease can accurately assess the coronary artery disease in the early stage of disease,and its sensibility is higher than that of traditional assessment method of coronary artery.2)The Z-score analysis of the coronary artery of children with kawasaki disease can objectively reflect the severity of coronary artery disease of children with kawasaki disease and the changing process of course of disease.3)There was significant correlation among the fever duration,platelet count of children with kawasaki disease and the severity of coronary artery lesion. |
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