Retrospective Analysis Of Clinical Characteristics And Related Influencing Factors Of Coronary Artery Lesions In Kawasaki Disease

Objective: In this paper,objective to provide help for the diagnosis and prognosis of KD through the analysis of the clinical symptoms and risk factors of coronary artery lesion(CAL)with Kawasaki disease in Department of Endocrinology,Rheumatology and Immunology,Anhui Provincial Children’s Hospital.Methods : Clinical data of all children with KD admitted to the Endocrinology,Rheumatology and Immunology department of Anhui Provincial Children’s Hospital from January 1,2016 to June 31,2022 were collected,155 cases were included.According to the diagnostic criteria,Sixteen cases were eliminated and 139 cases were finally included.Children with KD were divided into CKD group(98 cases)and IKD group(41 cases);Children with CAL were divided into CAL group(32 cases)and non-CAL group(107 cases).The basic information,clinical characteristics,laboratory indexes and concurrent coronary artery lesion(CAL)between CKD and IKD children were compared.To retrospectively analyze the clinical characteristics and risk factors of coronary artery lesions in patients with Kawasaki disease.Results:1.The number of male/female was 61/37 in CKD group and 24/17 in IKD group.There was no significant difference in gender between CKD and IKD groups(P>0.05).In CKD group,45 cases were 1-3 years old,19 cases were 3-5 years old,and 12 cases were>5 years old.In IKD group,the corresponding cases were 18,9,and 4.There was no significant difference in age between CKD and IKD groups(P>0.05).2.The CKD group was significantly different from the IKD group in terms of the duration of fever,conjunctival hyperemia,rash,lymphadenopathy,swelling of hands and feet,and the non-response rate to Intravenous Immune Globulin(IVIG)(P<0.05).3.The CKD group had a significantly higher percentage of Neutrophilic granulocyte(NEUT)than the IKD group(P<0.05).4.The incidence rate in the CKD group was significantly lower than those in the IKD group(15.31% vs 41.46%,P<0.05).5.Single factor analysis showed that there was a significant difference in the age factor between CAL and n CAL groups,P<0.05.The Hemoglobin(Hb)content in the CAL group was lower than that in the n CAL group,P<0.05.The CAL group showed significant differences in C-reactive protein(CRP),N-terminal pro brain natriuretic peptide(N-terminal pro brain natriuretic peptide,NT-pro BNP),NEUT percentage,and Erythrocyte sedimentation rate(ESR)in the n CAL group were significantly higher than those in the n CAL group(P<0.05).6.The risk of CAL increased with the increase of NT-pro BNP(OR: 2.562,95%CI:1.452-4.276)and the decrease of Hb(OR: 0.973,95%CI: 0.956-0.993)in the CAL group(P<0.05).Conclusion:1.The CKD group had more typical clinical symptoms such as conjunctival hyperemia,rash,lymphadenopathy,and swelling of hands and feet than the IKD group.The CKD group had higher IVIG response rate and NEUT percentage than the IKD group.2.IKD children are more likely to develop CAL.3.The age and Hb content of CAL children were lower,but NT-pro BNP were higher.Increased NT-pro BNP and decreased Hb may be independent risk factors for CAL.