| Objective: To understand the characteristics of the incidence ofKawasaki disease (KD) in our hospital, the epidemiologicalcharacteristics, clinical characteristics, diagnosis and treatment toprovide the reference for clinical diagnosis and treatment based onretrospective analysis of779cases of hospital treatment of KD patients.Methods: The medical records of hospitalized children withKawasaki disease in the department of pediatrics in the First AffiliatedHospital of Jilin University were analyzed retrospectively, during theperiod from2000January to2013December. All cases were inaccordance with diagnostic criteria revised at the Third InternationalConference on Kawasaki diseases. All the cases were divided intodifferent groups due to diverse aspects, including typical and atypical KDgroups, with and without coronary artery lesions (CAL, nCAL) groups,intravenous injection gamma globulin (IVIG) sensitive and non-sensitivegroups. The statistically comparative analysis was performed with thegeneral characteristics of the data and that derived from the main clinicalmanifestations and auxiliary examination of different groups of children.Results:1.The incidence of KD has shown an increasing tendency.The ages of the children at onset varied from2months to14years. Thecases of children under the age of years were201that accounted for 27.0%.~2years old,214cases (27.5%),157cases (20.2%)~3years old,76cases (9.8%)~4years old,48cases (6.2%)~5years old, under theage of years old708cases (90.9%).2.Out of779cases of KD patients,488cases were boys and291cases were girls, with a ratio of them was1.68:1.3.KD occurred all the year and the highest incidence of KD was inmay(83cases,10.7%), inJune (90cases,11.6%), while the lowestincidence was in February(34cases,4.4%). The peak incidence appearedto be in May and June. Spring and summer of453cases (58.2%)，Fall andwinter of326cases (41.8%).4.Fever was the most common clinicalfeature and the rest of clinical features were flushing, chapped lips（83.1%）, congestion of the bulbar conjunctiva (76.5%), red bayberrytongue (70%), rash (69.4%), fingers (toes) end membrane peeling(67.3%), cervical lymph node enlargement (66.8%), and swelling(55.4%), perianal skin (28.5%),(2.1%) and BCG vaccination as follows.The ultrasonic cardiogram of the patients that incorporated with291cases(37.4%) of CAL within the incidence of1months revealed that thediameters of242cases were lower than4mm (31.1%), diameters of47cases were in the range of4~7mm (6%), a giant coronary arteryaneurysm (GCAA) were found in2cases (0.3%). The cases of coronaryartery lesions (CAL) that with left coronary artery (44.3%) involved werethe most common, bilateral coronary artery (43.3%) involved, rightcoronary artery (12.4%).5.A total of typical KD606patients (77.8%), atypical KD cases were173patients (22.2%). The ratio of male to femalein typical KD cases was1.86:1, while in atypical KD cases was1.19:1.typical KD acuities were1year old children in142cases (23.4%),1~3years old children309cases (51.0%),3~5years old children99cases(16.3%),>5years old children with56cases (9.3%), incomplete KDacuities were1year old children in68cases (39.3%),1~3years oldchildren62cases (35.8%),3~5years old children,28cases (16.2%),15cases (8.7%)>5years old, the age structure, there are significantdifferences (P＜0.05). incomplete KD group NE%, CRP, ESR value islower than the typical KD group.A significant difference of gender andage (P <0.05) was found in this study. incomplete KD group NE%, CRP,ESR value is lower than the typical KD group.6.The ratio of cases inmale to female that combined with CAL was2.10:1, while ratio of caseswithout CAL was1.48:1. Merge CAL acuities were1year old children107cases (21.9%),1~3years old children242cases (49.6%),3~5years old children93cases (19.1%),46cases (9.4%)>5years oldchildren, group nCAL acuities were1year old children103cases(35.4%),1~3years old children129cases (44.3%),3~5years oldchildren34cases (11.7%),>5years old children with25cases (8.6%). Asignificant difference of gender and age (P <0.05) was found in thisstudy.Single factor analysis showed that the boy, age <1year old, fevertime>10d, ESR>100mm/1h, PLT increased (before and after treatment), AST rise, low HGB is KD merge CAL correlation factors.7.Single factor analysis showed that the heating time>10d, PLTincreased (before treatment), low serum sodium was IVIG no reactivityof correlation factors.Conclusion:1.The incidence of KD has shown an increasingtendency. KD is the most common in patients who are under the age of5years. The peak incidence of KD cases occurs in May and June. Theincidence of KD in spring and summer is higher than that happens in falland winter.2.The incidence of cases of children under the age of1year inatypical KD group appeared to be the highest.3.The independent riskfactors attributed to the combination of CAL are the patients who areyounger than1year, male and with the period of fever that is longer than10days.4.The independent risk factors attributed to the absent activity ofIVIG are the period of fever that is longer than10days. |
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