Acute Clinical Analysis Of Children Kawasaki Disease With Coronary Artery Lesions

OBJECTIVE:The objective of this research is to investigate the demographic characteristics, clinical manifestations, laboratory tests, and other conditions of systems of the Kawasaki Disease (for short KD) children with coronary artery lesions (for short CAL), providing a clinical basis for predicting and detecting this complications early.METHODS:By retrospectively analyzing 85 cases of KD children with CAL and 76 cases without CAL in Shandong Provincial hospital from June 2013 to January 2016, this research discusses the demographic characteristics, clinical manifestations, laboratory tests, and other conditions of systems of the KD children with coronary artery disease, providing a clinical basis for predicting and detecting this complications early.RESULTS:1.In general, most of the KD children is younger than 3 years old, with the 1.93:1 of male/female ratio. The male/female ratio of the KD cases with CAL (for short CAL cases) is 1.30:1, which is similar to the male/female ration of the cases without CAL (for short NCAL cases). However, the gender distributions of these two case groups are different. The result shows that children under 1 year old are more susceptible to CAL.2. The frequency of the main clinical manifestations:100% of the CAL case group had a fever lasting for more than 5 days. The average number of days of fever before diagnosis is 10.09+6.395, which is significantly higher than the NCAL case group. Compared with NCAL case group, there is significant difference in rash, lymph node nonsuppurative swelling, foot swelling and lip change, in which the morbidity of hand and foot swelling, rash and lymph node non suppurative enlargement occurring rate is low. CAL case group clinical manifestations of the patients meet the diagnostic criteria in children with Kawasaki disease accounted for 55.3% and met diagnostic criteria for clinical manifestations of 3 and below accounted for 44.7%, which satisfies the 316.5%,2 pieces of 27.1% and the condition is not met in that sphere and the change of the lips with membrane hyperemia, there was the highest.3. Cal group clinical manifestations of the patients meet the diagnostic criteria in children with Kawasaki disease accounted for 55.3% and met diagnostic criteria for clinical manifestations of 3 and below accounted for 44.7%, which satisfies the 3 16.5%,2 Article 27.1%, does not meet the conditions, lips change and ball with membrane hyperemia, there was the highest.4. Involvement of the system:The CAL case group appears to be associated with multiple system damage, with 4.7% of one system involvement accounted,95.3% of two or more system involvement,51.8% of more than three system involvement which is significantly higher than that of the NCAL case group. It is suggested that, when KD is associated with multiple system damage, the ultrasonic cardiogram should be conducted to check CAL.5. In the CAL case group,31 cases only occured left coronary artery,3 cases only occurred right coronary artery, and51 cases occurred both right and left coronary artery; 82 cases (96.5%) occurred left coronary artery change,54 cases (63.5%) occurred right coronary artery change. In left coronary artery,74 cases (87.1%) had the main increase width,39 cases (45.9%) had the anterior descending artery widened with,12 cases (14.1%)had circumflex artery widened, and 13 cases (15.3%) had the opening of the broadening. Additionally left coronary artery bifurcation and the origin place can appear widened. In right CAL,47 cases (55.3%) had the main increase width,10 cases (11.8%) had the opening of the broadening,28 cases had coronary artery aneurysm and 6 cases had giant coronary artery aneurysm,all of then occurred right main increase width.6. There is a significant difference of the morbidity of coronary artery aneurysm in the cases of male and female KD children. The morbidity of male is higher than that of female, but there is no significant difference in different age groups..CONCLUSION:1. In general, most of the KD children is younger than 3 years old, with the 1.93:1 of male/female ratio. The male/female ratio of the KD cases with CAL (for short CAL cases) is 1.30:1, which is similar to the male/female ration of the cases without CAL (for short NCAL cases). However, the gender distributions of these two case groups are different. The result shows that children under 1 year old are more susceptible to CAL.2. morbidity In main clinical manifestations, the morbidity of children rash, non-suppurative lymph nodes, hand and foot swollen and oral changes of CAL case group is significant lower than the NCAL case group, showing a smaller significance for the diagnosis of KD. However, the average number of days of fever before diagnosis of the CAL case group is significantly higher than the NCAL case group, suggesting that the longer the fever time, the higher the morbidity of CAL3. Lips change and global binding membrane hyperemia in cal group children appear rate is higher, and rash, extremities and neck lymph node enlargement of this group of incomplete Kawasaki disease in lower.4. KD children are always associated with multiple system damage. Therefore, when there are more than 2 systems involve, it is needed to be alert to the occurrence of CAL.5. In this study, patients with Kawasaki disease, patients with coronary artery disease in children with LCA alone and LCA+RCA involvement in two forms of the most common, left coronary artery more easily involved.6. There is a significant difference of the morbidity of coronary artery aneurysm in the cases of male and female KD children. The morbidity of male is higher than that of female, but there is no significant difference in different age groups.