Follow-up Of High Risk Factors For Kawasaki Disease No Response To Gamma Globulin

ObjectiveKawasaki disease(KD)is an acute exacerbation of rupture vasculitis,early use of high-dose gamma globulin to prevent coronary artery damage has reached a consensus,but some children with IVIG are no response,the incidence of the CAL is more significantly higher in the part of children.During follow-up,we researched and analyzed disease progression,c-reactive protein,white blood cells,platelets,myocardial enzyme,blood sodium and echocardiographic indexes of the children with kawasaki disease who had no reactive acrylic ball,and with acrylic ball sensitive analysis and comparison are made on the related parameters of children with kawasaki disease,Summarizing two groups of children complicated with the risk of coronary artery damage and related factors.In order to reduce the risk of coronary artery damage and provide the theory basis for early intervention of the clinical children with kawasaki disease who had no reactive acrylic ball.MethodsA total of 370 children diagnosed with Kawasaki disease were enrolled in our hospital from January 2011 to June 2015.Patients with age less than 2 years of age and 10 days of age were selected.According to the guidelines,high doses of gamma globulin Treatment,according to the clinical response after the application of gamma globulin is divided into A,B two groups(50 cases),A group of 48 hours is still sustained fever,or 2-14 days again fever and Kawasaki disease,one of the clinical manifestations,Considered for the IVIG non-reactive type KD,B group for the rapid heat back,clinical manifestations of inflammatory regression subsided,consider the C-ball sensitive type.Two groups of children were diagnosed in the first,the second,the third,the sixth month,the first and the second years related indicators such as C-reactive protein,white blood cells,platelets,myocardial enzymes,serum sodium and echocardiography were monitored,collected,And to organize the statistics of the two groups of children with changes in the indicators,coronary damage,analysis of the relevant laboratory indicators and the relationship between coronary artery damage.ResultsCoronary artery lesions were common in both groups.The incidence of group A was higher than that of group B.In the study of the first,the second,the third month,C-reactive protein and platelet count in group A were significantly higher than those in group B,there were statistically difference(P <0.05).The serum sodium level in group A was significantly lower than that in group B,there were statistically difference(P <0.05).The above two indexes returned to normal in the study of the sixth month,and there were no significant difference between the two groups(P> 0.05).In the study of first month,coronary artery damage had 40 cases: group A(n = 23)and group B(n = 17).In the study of the second month,The new occurrence of coronary artery injury had 10 cases: group A(n = 6)and group B(n = 4).In the study of the third month,The new occurrence of coronary artery injury had 8 cases: group A(n = 5)and group B(n = 3).In the study of the sixth month,The new occurrence of coronary artery injury had 2 cases: group A(n = 2)and group B(n = 0).In the study of the first and second year,There were no cases of coronary artery damage in the study group(Table 7).ConclusionThe children with kawasaki disease who have no reactive acrylic ball are more likely to have a higher risk of coronary artery damage.Therefore,strengthening follow-up,closely monitoring of c-reactive protein,white blood cells,platelets,myocardial enzyme,blood sodium and echocardiography index,This will help to early identify potential risks,active intervention,and then improve the long-term prognosis.