Meta Analysis Of The Risk Factors For Coronary Artery Lesion Secondary To Kawasaki Disease In Chinese Children

ObjectivesTo discuss the risk factors for coronary artery lesion secondary to Kawasaki disease in Chinese children.Data and MethodsIn this study, with developed strict inclusion and exclusion criteria, systematic evaluation was used to collect all domestic documents on the risk factors for coronary artery lesion secondary to Kawasaki disease.Search the Chinese Academic Literature Main Storehouse, Chinese Science and Technology Periodical Database, Ten Thousand Side Periodicals and the Dissertation Database, and the Chinese Biomedicine Literature Database comprehensively, besides, retrospective retrieval and manual retrieval were also used. From the domestic public theories and the dissertations dating from January,2000 to December,2009, the clinical materials and information about the high risk factors for CAL secondary to KD were collected. Include in the original study, evaluate the quality, extract the information and check over, then remove documents which were inappropriate for the purposes and standards of the study, finally confirm the data for the study.RavMan 4.2 provided by Cochrane was used for Meta Analysis. Select fixed or random model according to the literature results of heterogeneity test. Sensitivity analysis is done according to the different results. The publication bias is evaluated by funnel plots. Odds Ratio (OR) and 95% Confidence Interval (CI) were estimated in the dissertation.Results20 studies including a total of 4737 cases of patients meet the inclusion criteria. And 1458 cases of patients with coronary artery lesion were confirmed. All of the 20 studies were retrospective studies.OR and 95% CI were as follows:Age<=1 year, OR=1.58, and 95%CI=[1.23,2.04],p=0.0004;Male gender, OR=1.48,95%CI=[1.29,1.71],p<0.00001;PLT<300×109/L, combined OR=0.85,95%CI=[0.62,1.15],p=0.29, the difference was not statistically significant;WBC>20×109/L, combined OR=1.73,95%CI=[1.32,2.26],p<0.0001;CRP>100mg/L, combined OR=2.37,95%CI=[1.49,3.77],p=0.0003;ESR>100mm/h, combined OR-1.34,95%CI=[1.02,1.75],p=0.03, but the conclusion was not stable;Fever duration>10days, combined OR=3.23,95%CI=[2.08,5.02],p<0.00001;Use of intravenous gamma immunoglobublin (IVIG)>10days, combined OR=2.50,95%CI=[1.98,3.16],p<0.00001.Conclusions1. The high risk factors for coronary artery lesion secondary to Kawasaki disease are age<=1 year, male, WBC>20×109/L, CRP>100mg/L, fever duration>10days, and use of intravenous gamma immunoglobublin (ⅣIG)>10days.2. OR as a effective index, according to the Wynder standard, the correlation between male gender and coronary artery lesion secondary to Kawasaki disease is weak; the correlation between age<=1 year, WBC>20×109/L, CRP>100mg/L, use of intravenous gamma immunoglobublin (IVIG)>10days and coronary artery lesion secondary to Kawasaki disease is moderate; the correlation between fever duration>10days and coronary artery lesion secondary to Kawasaki disease is strong.3. Because all of the 20 studies were retrospective studies, and maybe there was some omission in the design, some kinds of bias could arise. As a result, further conclusions need to be drawn through a number of well-designed, large sample prospective studies.