Clinical Analysis Of Kawasaki Disease

Objective:To understand the incidence,clinical features of Kawasaki disease (Kawasaki disease, KD) through clinical retrospective analysis. To compaire the clinical characters of typical and incomplete KD.To compaire the therapeutic effect of different dose method of intravenous immune globulin (IVIG),and analyze the influential factors of refractory KD and coronary artery lesion (CAL) caused by KD.Methods:Clinical data of 126 cases with Kawasaki disease who hospitalized in. Department of Pediatrics, the First Affiliated Hospital Of Guangxi Medical University, from January 2003 to December 2009, were collected. Recording the onset, season, ages, sex, clinical manifestation, ultrasonic cardiography(UCG), electrocardiogram(ECG), thoracic roent genoscopy, routine blood test, C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), aspartate aminotransferase((AST), albumin (ALB), creatine phosphokinase isoenzyme (CK-MB), hemoculture, anti-mycoplasma pneumoniae(MP-IgM), routine urine test,etc. analysis through statistics:(1). clinical features of 126 cases with KD were summaried; (2).clinical characters of typical and incomplete KD were compared; (3). the risk factors of coronary artery lesion (CAL); (4). therapeutic effect of three different dose methods of IVIG were compared;(5). the influential factors of refractory KD.Results:1.126 cases with KD,which the age under five years old is susceptible to(accounted 96.0%), especially under three years old (accounted 77.8%),and more boys are easily gotten than girls(male:female of 2.5:1), can occur in whole year, but more than in spring and summer (accounted 57.1%); 2. Incomplete KD, which infants was susceptible to, had low prevalence of all major clinical manifestation than those of typical cases (P<0.05 or 0.01), and had prolonged fever duration before being diagnosised. AS compared with the typical KD, it had markedly higher incidence of CAL (P<0.01); 3. Logistic regression analysis revealed that age under three years was risk factor of CAL in Kawasaki disease; 4. In comparison of three different IVIG dosage methods on the pyretolysis time and therapeutic reaction, lg/kg×1d and 1g/kg×2d were superior to 400mg/kgx5d (P=0.002or0.000), but there had no difference between 1g/kg×1d and 1g/kgx2d(P>0.05); 5. The fever duration and dose methods of IVIG were independent correlation factor of refractory KD; the fever duration was protective factor,and IVIG dose method was risk factor.Conclusion:1. KD,which Boys under five years old are susceptible to, often occurs in spring and summer more; 2. Incomplete KD, which infants are susceptible to, has lower incidence of all major clinical manifestation than those of typical KD,and has prolonged fever duration before being diagnosised, but markedly higher incidence of CAL; 3. age under three years was risk factor of CAL in KD; 4. on the pyretolysis time and therapeutic reaction, 1g/(kg.d)×1d was the more economic and effective treatment option of IVIG; 5. the fever duration and dose methods of IVIG were independent correlation factor of refractory KD.