Comparative Study Of CAL In Complete And Incomplete Kawasaki Disease

Objective:To explore the difference of coronary atery lesion(CAL)in complete Kawasaki disease(cKD)and incomplete Kawasaki disease(iKD)in children.Method:The clinical data of 1514 cases of hospitalized children with Kawasaki disease from January 2014 to December 2015 were retrospectively analyzed and compared between the children with cKD and those with iKD.The risk factors of CAL were analyzed.Results:There were 1094 cases(72.3%)of cKD and 420 cases(27.7)of iKD in 1514 children with KD.The incidence of CAL in all KD children was 51.9%.the distribution of different degree of CAL between cKD group and iKD group was statistically different(P<0.01)The incidence of echo enhancement or small coronary artery aneurysm in cKD group(50.4%)was higher,and the incidence of giant coronary artery aneurysm in iKD group(2.4%)was relatively higher.The incidence of thrombosis in iKD group was 3.3%,which was significantly higher than that in cKD group(0.6%)(P<0.001).The time when CAL was found first by clinical ultrasound echocardiography in cKD group and iKD group were 7.84?2.97 d and 8.47?2.89 d,respectively,and there was statistical difference(P<0.05).The most frequent involvement was left main trunk in CAL in children with KD.The proportion of simultaneous involvement of the left and right coronary arteries,only right stem involvement,and whole left coronary artery involvement in were significantly higher in cKD group than those in i KD group,while the proportion of left main trunk involvement was significantly higher in i KD group than that in cKD group(all P <0.05).Male is the high risk factors for CAL,and intravenous infusion of immunoglobulin(IVIG)in 5~10 days of course of disease was the protective factors for CAL.Conclusion:Giant coronary artery aneurysms and thrombosis,are more common in children with iKD.In iKD,the left coronary artery is mainly involved in CAL,and in cKD,the simultaneous involvement of left and right coronary artery is more commom in CAL.Use IVIG during 5 to 10 day can reduce occurrence of CAL.