Clinical Characteristics Analysis Of Kawasaki Disease In Children From 2012 To 2015 In Yancheng Urban District

Objective: To understand the epidemiological characteristics and clinical features of Kawasaki disease(KD) in Yancheng urban district from 2012 to 2015 hospitalization in children.(1) To compare the clinical characters of complete KD with incomplete KD.(2)To analyze the high risk factors of the coronary artery lesion(CAL)in KD.(3)To follow-up coronary artery damage with echocardiography coronary recovery.Methods: Through the analysis of the clinical data of children with Kawasaki disease hospitalized in Yancheng First People’s Hospital, Yancheng City Third People’s Hospital and Yancheng Maternal and Child Health-Care Center from 2012 to 2015, to explore the single factor analysis of CAL concurrent KD by SPSS20.0 statistical software with X2 test.Measurement data were showed by X ±s and were calculated by t test. A value of P <0.05 was considered statistically significant.Results:(1)There were 129 inpatients diagnosed as KD in Yancheng urban district from 2012 to 2015. The male/female ratio was nearly 2:1. 76(58.91%)occurred among children<2 years of age,120(93.02%)occurred among children<5 years of age,9(6.98%)occurred among children>5 years of age. The frequency of the clinical features in KD are different. All children have a fever. The highest incidence of KD was lips and oral mucosa changes, accounting for 91.47%.Secondly was Polymorphic rash, accounting for 88.37%.Cervical lymph node enlargeement accounts for 84.50%. Extremity change and Conjunctival congestion various accounts for 83.40% and 81.72%.The lowest was changes around the anus,accounting for 64.34%.The incidence of KD complicated with cardiac involvement and CAL was 38.76%.(2) Comparison between complete KD group with incomplete KD group:The incidence of complete KD was 79.84%(103 cases),and incomplete KD was 20.16%(26 cases). In terms of the onset age, KD group completely opposite concentration lower than 3 years old, and incomplete KD groups of all ages averagely. The fever duration before diagnosis in incomplete KD was7.83±3.37 days,which was longer than that in complete KD(6.07±2.25days)(P<0.05). Total duration offebrile in incomplete KD was 9.23±3.45 days,longer than that in complete KD 8.04±2.17 days,there were significant differences(P<0.05). On clinical manifestations,Incomplete KD group the anus skin changes(73.07%) was obviously higher than complete KD group(63.10%),which the difference between them was statistically significant(P<0.05).Laboratory test results:percentage of neutrophil(N%),alanine aminotransferase(ALT),aspartate aminotransferase(AST),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP) in complete KD were higher than those in incomplete KD(P<0.05).Blood platelet(PLT) was increased in acute and subacute stage, in which the subacute stage increased obviously, incomplete KD was higher than complete KD.Albumin(ALB) and prealbumin(PA) was decreased,in which w incomplete KD was lower than complete KD(P < 0.05). Albumin、prealbumin、serum sodium was decreased,in which complete KD was was statistically significant than incomplete KD(P < 0.05). Among 10 cases of intravenous gamma globulin in children with KD who was no reaction,CALwas 7cases.(3) CAL coronary arteries in children with follow-up: Coronary artery intima echogenicity was 28 cases,among which 9 cases recovery in one month, 23 cases revovery in 3 months and 27 cases in 6months. Coronary artery expansion was 13 cases, among which 5 cases recovery in 6 months, one year accumulative total recovery 10 cases and 12 cases accumulative total recovery two years.There were 6 cases of coronary artery aneurysms,which 2 cases returned to normal within 2 years, 1 case of 2 years follow-up coronary artery not recovered, 3 cases of follow-up of patients within a year, coronary artery did not recover, which is still in follow-up.Conclusions:(1) Yancheng urban district infants and young children that lower than 3years old was the peak age with KD, and incomplete KD all ages averagely.(2) The anus skin changes can help diagnose incomplete KD.(3) Average time of fever,the decreasing of Hb、Hct、ALB and the increasing of CRP、ESR、PLT and no response with IVIG were the risk factors of KD concurrent CAL.(4) CAL restore follow-up coronary artery, children with mild damage to the arteries(coronary artery intima echogenicity) mostly back in 3months,most cases of coronary artery expansion to recover within one year.The longest time to revovery in nomal was coronary artery aneurysm.