| Background and significance:Kawasaki disease(incomplete Kawasaki disease,iKD),Kawasaki(cKD)also known as the typical Kawasaki disease disease,easily diagnosed in clinical disease;incomplete Kawasaki(incomplete Kawasaki disease,iKD)because of the risk of the atypical clinical symptoms and complications,and laboratory index for clinical diagnosis reference without obvious specificity the diagnosis is difficult,as more and more researchers are welcomed.Incomplete Kawasaki disease(iKD)the possibility of children with coronary artery lesions was significantly higher than that of Kawasaki disease(cKD)with incomplete Kawasaki disease(iKD)because of its atypical symptoms,diagnostic criteria were consistent,is no longer applicable in clinical work,looking for a complete and correct diagnosis standard is particularly important?A large number of iKD and cKD contrast study showed that both clinical manifestations of differences,but there are many similarities in the relevant indicators of clinical laboratory?complete Kawasaki disease(cKD)with most of the typical clinical symptoms to diagnosis,laboratory abnormalities and infectious diseases is not much difference,incomplete Kawasaki disease(iKD)from etiological analysis there are factors of infection caused by the incidence mechanism,thus significantly changes the laboratory inflammatory index for the diagnosis of incomplete Kawasaki disease has certain diagnostic significance?At the same time incomplete Kawasaki disease(iKD)in immune system activation may not be complete Kawasaki disease(cKD)?However,the clinical manifestation is less,so the exploration of immune index has certain value in differential diagnosis?So in 2004 the American Heart Association(American Heart Association,AHA)in the incomplete Kawasaki disease diagnosis standard assessment,included in the related infection index,including WBC,ESR,CRP,PLT and other 8 indicators of inflammation,contribute to the incomplete Kawasaki disease early diagnosis?Some researchers in immune indicators as analysis Kawasaki Kawasaki disease and incomplete differential diagnosis of diseases as a breakthrough point,and have a certain significance,provides the theoretical basis for the later application of gamma globulin.The purpose of this study is based on the Second Affiliated Hospital of DA LIAN Medical University for 3 years in 87 cases Retrospective analysis of Kawasaki disease cases,combined with laboratory results,timely assessment of severity of inflammation and immunity,and the possibility of vigilance for coronary artery lesions,underwent coronary artery color Doppler ultrasound examination for early diagnosis and early treatment.Method: The Second Affiliated Hospital of DA LIAN Medical University from January 2014 to January 2017 infants hospitalized from Kawasaki disease patients a total of 104 cases,excluding not perfect relevant examination system of Kawasaki disease in children,a total of 87 were selected,and record the children's age,gender,duration of fever and general situation,laboratory examination,echocardiography and other laboratory tests including.Index,complete : white blood cell count(WBC),hemoglobin(Hb),platelet count(PLT),erythrocyte sedimentation rate(ESR),Creactive protein(CRP),alanine aminotransferase(ALT),plasma albumin White(ALB),immunoglobulin A(Ig A),immunoglobulin M(Ig M),immunoglobulin G(Ig G),T cell subsets(CD4+,CD8+,CD3+)and echocardiography,42 cases were male,45 were female,according to the clinical diagnostic criteria,divided into cKD two,iKD group.Summarize and analyze the 87 cases of Kawasaki disease were age,gender,duration of fever and other general situation;relating to differences in laboratory examination indexes were compared between the two groups of cKD and iKD,heart color Doppler check all the children were in hospital before treatment,mainly observed in children with coronary artery lesions(no CAL).Data were analyzed by SPSS19.0 statistic software,statistical analysis of the clinical and laboratory data.Count data using chi square test,quantitative data were presented as mean±standard deviation(X±SD)said,compared with the measurement data of normality using independent samples t test,P < 0.05 there was statistically significant(KD).Kawasaki disease factors in patients with coronary artery lesion with cross table X2 test,single factor analysis,after multivariate analysis using Logistic regression analysis,P < 0.05 was considered statistically significant.Result: 1.There was no significant difference in age and sex between the complete Kawasaki disease(cKD)and incomplete Kawasaki disease(iKD),suggesting that there was no significant difference in age and sex between the two groups?2.Complete Kawasaki disease(cKD)and incomplete Kawasaki disease(iKD)had statistical significance in inflammatory indexes of white blood cell count and CRP,humoral immunity without statistically significant(P > 0.05),the ratio of CD3+ and CD4+/CD8+ in cellular immunity was statistically significant in Statistics(P < 0.05)?3.Kawasaki disease(KD)complicated with coronary artery lesions(CAL)risk factors analysis: age < 1 year old OR=3.305,95% CI ?(1.401,7.794),P=0.027;CRP > 100 mg/L OR = 4.625,95% CI(0.899,5.742),P = 0.014;ESR > 100 mm/h OR=3.476,95 % CI(0.765,6.447),P=0.007;WBC> 20×109 /L OR = 3 842,95% CI(1.562,9.453),P = 0.000?Conclusion: 1.The white blood cell count,CRP,CD3+,CD4+/CD8+ changes in the clinical differential diagnosis of complete Kawasaki disease(cKD)and Kawasaki(iKD)when the disease has a certain significance.2.Kawasaki disease(KD)in children with age < 1 year,CRP> 100mg/L,ESR> 100mm/h,WBC > 20×109/L,as Kawasaki disease(KD)complicated with coronary artery lesions(CAL)risk factors. |
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