Clinical Characteristics Analysis Of921KD Patients From2006to2013in Children’s Hospital Of Soochow University

Objective: To investigate the epidemiologic pictures and clinical features ofKawasaki disease（KD）in Suzhou from2006to2013.(1) Clinical retrospective analysiswas done to summarize the epidemiologic pictures and clinical features of Kawasakidisease（KD）.(2) To compare the clinical characters of complete KD with incomplete KD．(3)To analyze the high risk factors of the coronary artery lesion（CAL）in KD.Methods: Retrospective reviews of medical records from the Children’s Hospital ofSoochow University were done to identify KD inpatient cases from2006to2013. The highrisk factors of CAL in KD were investigated. Univariate analysis and multivariate logisticregression analysis with CAL were performed to explore the high risk factors for CAL.Thedata were analyzed by SPSS19.0software with X2test. Measurement data were showed byX±s and were calculated by t test. A value of P <0.05was considered statisticallysignificant.Results:(1)There were921inpatients diagnosed as KD in the Children’s Hospital ofSoochow University from2006to2013. The male/female ratio was1.83:1.606（65.80%）occurred among children<2years of age,829（90.01%）occurred among children<5years ofage,92（9.99%）occurred among children>5years of age. Although KD occurs year-round,somewhat higher incidences were seen from March through June. The percentage ofpatients who were diagnosed as complete KD was74.05%. All patients had fever.Thehighest incidence of KD was conjunctival injection, accounting for82.84%(763cases),thelowest was recurrent redness and erythema at Bacille Calmette-Guèrin(BCG) inoculationsite,accounting for12.38%(114cases).The incidence of KD complicated with cardiacinvolvement and CAL was27.04%and25.30%respectively. Approximately4.44% patients had no response to intravenous immunoglobulin(IVIG).(2)comparing completeKD with incomplete KD:The incidence of complete KD was74.05%(682cases),andincomplete KD was25.95%(239cases).The incidence of complete KD under1year oldwas35.34%(241cases),and incomplete KD was44.77%(107cases),there were significantdifferences(P<0.05).The age of complete KD was26.82±23.43months,and incomplete KDwas23.26±22.40months,there were significant differences (P<0.05). The fever durationbefore diagnosis in incomplete KD was7.94±3.40days, longer than that in complete KD(6.37±2.35days)(P<0.05).Duration of febrile in incomplete KD was9.33±3.46days,longerthan that in complete KD (8.27±2.33days)(P<0.05). Incomeplete KD had lower prevalenceof all major clinical manifestation than those of complete KD(P<0.05),except perianaldesquamation and recurrent redness and erythema at BCG inoculation site. percentage ofneutrophil(N%),alanine aminotransferase(ALT), aspartate aminotransferase(AST),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP) in complete KD werehigher than in incomplete KD(P<0.05).Blood platelet (PLT),albumin(ALB),prealbumin(PA),sodium(Na) in incomplete KD were higher than in complete KD (P <0.05). Theincidence of CAL in incomplete KD under one year old was significantly higher than incomplete KD(P<0.05).（3）Persistent decreased Hb,Hct,ALB and elevated CRP,ESR,PLT,Nonresponse to IVIG,male,total duration of fever(>10days) were significantly relatedto the incidence of coronary artery lesion (P<0.05).Multivariate Logistic regressionanalysis indicated that elevated PLT,persistent decreased Hct,ALB,male,total duration offever(>10days)were independently correlated with CAL secondary to KD.Conclusions: This research approximately reflects that:（1）the male children have ahigher incidence than female children in Suzhou,the peak age is below two years old,KDoccurred more frequently in spring. conjunctival injection is the most common clinicalsymptom except for fever.（2）The incidence of incomplete KD under1year old washigher than that of complete KD.The incidence of CAL in the <1year old group inincomplete KD was higher than in complete KD.The fever duration before diagnosis andduration of febrile in incomplete KD were longer than in complete KD.(3)Persistent decreased Hb, Hct, ALB and elevated CRP,ESR,PLT,Nonresponse to IVIG,male,totalduration of fever(>10days) were significantly related to the incidence of CAL.ElevatedPLT,persistent decreased Hct,ALB,male,total duration of fever(>10days) wereindependently correlated with CAL secondary to KD.