| Aim:To know the incidence, prevalence, clinical presentation, diagnosis and treatment, and prognosis follow-up of 131 cases with Kawasaki disease in our hospital within four years .Method:Retrospective analysis on 131 patients who were accurately diagnosed as Kawasaki disease in our hospital from March of 2004 to June of 2007. According to the new diagnosis standard which was revised by the third International KD Conference, the cases were classified again, of 131 cases, 90 cases are typical KD and the other 41 cases are incomplete KD. By analyzing the clinical presentation(including the constitutional rate of age, main symptoms and the characteristic change of this disease),laboratory inspection and various treatments (aspirin, intravenous immunoglobulin(IVIG) and corticosteroid),the 131 cases with Kawasaki disease were divided into three groups, and each group was given difference dose intravenous immunoglobulin (IVIG). The results of statistic analysis showed that there is no statistic significance.Result:1.Comparative analysis of incidence rate of KD among boy patients and girl patients: 83 boys get KD and 48 girls get KD, the rate is 1.73:1.2.131 children were divided into groups according to age of incidence; the statistics show that incidence rate of disease is different among ages. 86 children are under 3 years old, which accounts for 65.45; 34 children are between 3-6 years old, which accounts for 26.1% and 11 children are between 6-14 years old, which accounts for 8.5%.3.Among 131 patience who were divided into typical group and non-typical group according to the KD diagnosis standard and incomplete KD diagnosis revised by the 3rd International KD Conference, 90 children got typical KD, which accounts for 68.7%, 41 children got incomplete KD, which accounts for 31.3%. 104 cases (79.3%) were accurately diagnosed as KD when hospitalized, and 27 cases (20.6%) were diagnosed as other diseases, including 2 cases with blood poisoning, 17 cases with upper respiratory infection, 3 cases with acute lymphadenitis,2 cases with acute epidemic parotitis ,and 1 case with essential thrombopenia. 111 children were also diagnosed as the other diseases, such as virosis cardiomyopathy, acute bronchitis, alveobronchiolitis,diarrhea, suppurative encephalitis,congenital heart disease,capsula lienis,urinary system affect and anaemia.4.Among these 131 cases, 116 cases were diagnosed within 10 days when they got diseases, and 44 of them appeared coronary arteriectasia (4 cases got coronary aneurysm,1 case got giant coronary aneurysm), and the incident rate of coronary arteriectasia is 37.9%; 15 cases were diagnosed 10 days later, among them 10 cases appeared coronary arteriectasia (2 cases got coronary aneurysm,1 case got giant coronary aneurysm), and the incident rate is 66.7%.5.All the children spend the time from 1 day to 25 days in the hospital, and the days of average hospitalization is 11.47 days. 80.8% children were given accurate diagnosis three days later.6.There are a variety of clinical manifestations for the children with KD. 60% to 70% of clinical manifestations appeared from 3 to10 days when they got ill. However, the incidence rate of disease of the above clinical manifestations is different between typical KD and non-typical one.7.The data show that there are no obvious differences in age and sex between typical KD and incomplete KD. The degree and time of clinical manifestation that occurred are also different. For the degree of clinical manifestation of incomplete KD is comparatively lighter, most of clinical symptoms appear less and later. Because of the lighter reaction of blood vessel immunity inflammation, less attention being paid and untimely diagnosis and treatment, it leads to long time fever and serious blood vessel inflammation reaction and the increase of incidence rate of CAL. There are some different aspects between typical KD and non-typical one, such as clinical manifestation, laboratory inspections, coronary artery lesion and prognosis.8.The 131cases with Kawasaki disease were divided into three groups, and each group was given difference dose intravenous immunoglobulin (IVIG). The results of statistic analysis showed that intravenous immunoglobulin (IVIG) can reduce the icidence rate of CAL.and make CAL come back quickly,the time in the hospital,time of defervescence,haematoblast,blood heavy,C reaction albumen fall,show immunoglobulin cure KD have curative effect。IVIG can prevent CAL to occur and accelerate CAL to come back.Conclusion:1.The incidence rate of KD has been increased year by year. This kind of disease has no obvious seasonal feature. More boys get KD than girls. And they are almost get ill between 0-3 years old. The incidence of incomplete KD has been increased gradually, but the misdiagnosis is a bit higher. There are some different aspects between incomplete KD and typical KD, such as clinical manifestation, laboratory inspection,coronary artery lesion,and prognosis.2.The disease incidence of incomplete KD is increasing in recently years as well as the misdiagnosis rate. There is no obvious difference in age and sex between incomplete KD and typical KD. The time of fever lasted longer before final diagnosis of incomplete KD, and the incident rate of CAL is higher.3.The change of coronary artery is the most serious complication of KD. The data show that the longtime fever, the raise of C reactive protein and the obvious increase of blood sedimentation are closely related with CAL. There is an increasing danger to the children with concurrent CA,L who are not given IVIG treatment during the early time.4.Early and rational using r-Globulin can prevent and reduce coronary artery lesion. Through statistical analysis we can know that treatment will be better within 10days, and the incident rate of CAL will be increased with IVIG in 10 days. Using 1g/kgγ-globulin is the most economical and most effective treatment scheme. And the incident rate of CAL is higher for some children who is resisted to the drug of IVIG than those who are sensitive to the drug.5.We should reinforce the follow-up at this disease, observe the long-term consequence of regressed coronary artery lesion and take corresponding measures. The recovery rate of CAL for the patients who received IVIG treatment is much higher than those who didn't use this kind of treatment within two years, which shows that IVIG is helpful to the CAL.
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