Clinical Epidemiological Study Of Children With Kawasaki Disease In Enshi Area

Objective: This study was designed to retrospectively study a hospitalized child diagnosed with Kawasaki disease(KD)between 2013 and 2017 in the Enshi area.Based on the clinical data of inpatients with KD in Enshi area in the past 5 years,the prevalence and clinical epidemiological characteristics of children with KD in Enshi area were discussed.The clinical features of complete Kawasaki disease(CKD)and incomplete Kawasaki disease(IKD)were discuss.Independent risk factors for coronary artery lesions in children with local KD provide evidence-based evidence for clinical diagnosis and treatment.Methods:A total of 290 children with KD diagnosed and hospitalized from January2013 to December 2017 in 19 hospitals including Hospital Affiliated to Hubei University for Nationalities in Enshi District were collected,general data including gender,age,ethnicity,family address,as well as clinical manifestations,laboratory indicators and cardiac ultrasound results were collected,and to compare the case characteristics of complete Kawasaki disease and incomplete Kawasaki disease,finally,the risk factors of concurrent CAL were analyzed..SPSS17.0 software was used for statistical analysis.Frequency or constituent ratio(%)was used to describe the distribution of the counting data.Chi-square test /Fisher exact probability method was used to compare the distribution differences among different groups,Mean±SD was used to describe the distribution of normal distribution data,and t-test was used to analyze the differences between groups.Median(IQR)was used to describe the distribution of non-normal distribution,and Wilcoxon rank sum test was used to analyze the differences between groups.Regarding whether to merge CAL or not as dependent variable,the single factor analysis of the counting data and the measurement data is made respectively,and the logistic regression model is used to analyze the multiple factors to explore the influencing factors.The test level was alpha=0.05(bilateral),P<0.05 was statistically significant.Results:1.A total of 290 cases were collected.The number of cases showed a slowupward trend year by year.From 2013 to 2017,the number of specific cases was 58 cases,60 cases,51 cases,59 cases and 62 cases,respectively.2.Among 290 cases,183 cases were male(63.10%)and 107 cases were female(36.90%).The ratio of male to female was 1.71:1.The number of male cases was more than that of female cases.3.There were 200 children aged from 3.1 to 5 years old,accounting for 68.97%of the five-year data,51 children under 1 years old,accounting for 17.59% of the five-year data,and 39 children over 5 years old,accounting for 13.45% of the five-year data.It can be seen that Kawasaki disease predisposes to children between 1and 5 years old.4.Children suffer from KD all year round.From the case data,97cases(33.45%)in spring,98 cases(33.79%)in summer,50 cases(17.24%)in autumn,and 45 cases(15.52%)in winter.The cases are mainly concentrated in spring and summer.5.There are differences in ethnic composition,including 130 cases of Tujia(44.83%),125 cases of Han(43.10%),29 cases of Miao(10%)and 6 cases of Dong(2.07%).6.Three most common clinical manifestations were fever(100%),pharyngeal congestion(76.21%)and bilateral conjunctival non-suppurative hyperemia(73.79%),while three most common non-specific clinical manifestations were cough(38.97%),diarrhea(9.31%)and vomiting(8.97%).7.There were 188 cases of complete Kawasaki disease and 102 cases of incomplete Kawasaki disease,the ratio of the two was 1.84:1.The proportion of male and female children in incomplete Kawasaki disease group was larger than that in complete Kawasaki disease group,and the average age of onset was smaller than that in complete Kawasaki disease group.The differences in gender and onset age were statistically significant,with P values of 0.014 and 0.017,respectively.There were no significant differences in total calorific duration,Mycoplasma pneumoniae infection and IVIG treatment effect,P values were 0.505,0.282 and 1.00,respectively.8.Logistic regression analysis of risk factors for Kawasaki disease complicated with coronary artery lesion: Univariate analysis showed that mycoplasma pneumoniaeinfection,age,fever time,white blood cells,platelets,C-reactive protein and erythrocyte sedimentation rate were risk factors for Kawasaki disease complicated with coronary artery lesion.Multiple regression analysis results Showing age,fever time,white blood cells and C-reactive protein were risk factors for Kawasaki disease complicated with coronary artery lesion.Conclusions:1.The incidence of Kawasaki disease in Enshi area has been increasing slowly in recent five years,but it is smaller than other provinces and cities in China.The incidence is throughout the year,and the two peak season are spring and summer.Male children are more than female children.The age of onset is more common in children aged 1 to 5 years.Fever is the most common clinical manifestation,Fever is the most common major clinical manifestation,followed by pharyngeal congestion and bilateral conjunctival non-suppurative congestion,while other non-specific clinical manifestations is cough.2.Complete Kawasaki disease is the most common type of diseases.The incomplete Kawasaki disease predisposes to younger and male children.3.The younger the age,the longer the fever time,the higher the white blood cells and C-reactive protein in acute stage are the high risk factors of coronary artery lesion in Kawasaki disease.