Risk Factors For Coronary Artery Lesion In Children With Kawasaki Disease

Objective:To analyze the risk factors of coronary artery injury(CAL)in children with kawasaki disease(KD),and to provide evidence for the prevention and follow-up of CAL in children with KD.Methods:A total of 500 children with kawasaki disease were identified in the children’s hospital affiliated to chongqing medical university from May,2017--February,2018,and 243 cases in NCAL group,237 in CAL group(excluding CAA),and 20 cases in CAA group.Statistical analysis was performed on the age,gender,clinical manifestation,laboratory related indicators,and the time of use immunoglobulin in the three groups.Results:Single factor analysis showed that the male ratio of CAA and CAL group was higher than that of NCAL group(χ~2=10.638,8.545,P<0.017),and the age of CAL group was younger than that of NCAL group.The heating time of CAA group was higher than CAL and NCAL group(P<0.017).The white blood count of CAA group was higher than CAL group(P<0.017);The PLT of the CAA group was higher than the CAL group(P<0.017),The PLT of the CAL group was higher than the NCAL group(P<0.017).In CAA and CAL group,Hb was lower than NCAL group(P<0.017),and the lowest level of albumin in CAA group,followed by CAL group,and highest in NCAL group.The time of use immunoglobulin in the CAL group was higher than that in the NCAL group.(χ~2=11.902,P<0.017).Independent risk factors of multiariable Logistic regression analysis results showed that age,gender,Hb,albumin,the time of use immunoglobulin are the independent risk factors for CAL(P< 0.05);Gender,fever duration,PLT and albumin are the independent risk factors for CAA(P < 0.05).ROC curve from logistic regression analysis of the independent risk factors,find out the various risk factors vertices,the result shows: the age less than 3 years(P < 0.05,the area under the ROC curve Az = 0.6),Hb less than 105 g/L(P < 0.05,Az = 0.611),albumin less than 40 g/L(P < 0.05,Az = 0.595)is a risk factor for CAL;The heating time more than 10 days(P<0.05,Az=0.702),PLT more than 427*109/L,(P<0.05,Az=0.743),albumin less than 36g/L(P<0.05,Az=0.752)is the risk factor of CAA in children with KD.Conclusion:1.Male,small age(<3 years old),Hb decreased(<105g/L),and IVIG resistance are the high risk factors for CAL in children with KD;2.The decrease of albumin is a high risk factor for CAL in children with KD,and the lower the albumin,the greater coronary artery injury;3.High fever duration(>10 days),PLT elevation(>427*109 /L)are high risk factors for CAA in children with KD.