Single Center Clinical Study On Risk Factors For Kawasaki Disease With Coronary Artery Lesion

Objective:The clinical features,clinical efficacy and related risk factors of Coronary artery lesion,of Kawasaki disease in Ganzhou people's Hospital,was explored and targeted provide guidance for the diagnosis,treatment and prognosis judgment of Local Kawasaki disease.Methods:The clinical data of 300 children with KD admitted to Ganzhou people's Hospital from January 2013 to December 2018 were analyzed retrospectively,including age,sex,clinical manifestation,laboratory indexes?CRP,ESR,PCT,WBC,Hb,PLT,ALT,AST,ALB,Na⁺,CK-MB,PLR,NLR,25-?OH?D₃?and echocardiography.The factors,whether conforms to CAL or not,were analyzed by univariate analysis,and the meaningful variables selected were further analyzed by Logistic multivariate regression analysis to find out the independent risk factors of KD complicated with CAL.Results:1.The male-to-female ratio was 1.61,then 185 male children?61.67%?and 115female children?38.33%?.With a total of 168 cases?56.00%?,the proportion of children,under 2 years old,was relatively high;The proportion of children in the CAL group was 46?63.89%?,in the<2-year-old group,higher than the NCAL group?51.32%?.In the 5-year-old and>5-year-old groups,the proportion of children in the CAL group was 15?20.83%?and 11?15.28%?respectively,which was lower than that of 65?28.51%?and 46?20.18%?in the NCAL group.Unfortunately,There were no significant difference in age between two groups.2.There were 52 cases?72.2%?in male and 20 cases?27.8%?in female in CAL,then 133 cases?58.3%?in male and 95 cases?41.7%?in female in NCAL.The difference between the two groups was statistically significant?P<0.05?.3.In all children with KD,the incidences of clinical symptoms and signs from high to low were fever,bulbar conjunctival congestion,cleft lip,cervical lymph node enlargement,rash 263?87.7%?,bayberry tongue 228?76.0%?,limb change 220?73.3%?,perianal peeling 202?67.3%?,except fever,the incidence of clinical symptoms and signs was as follows:fever,bulbar conjunctiva congestion,cleft lip,cervical lymph node enlargement,rash 213?71.00%?,bayberry tongue 182?60.7%?,limb change 118?39.3%?,perianal peeling 86?28.7%?;Bulbar conjunctival congestion was the most common clinical manifestation;The incidence of cervical lymph node enlargement and limb changes in different age groups was significantly different among the three age groups?P<0.05?.There was no significant difference in other clinical manifestations among the three age groups(?P>0.05?.4.The clinical symptoms of cervical lymph node enlargement,limb changes and perianal desquamation,36 cases?50.0%?and 34 cases?47.2%?,were significantly higher in CAL group than those in NCAL group,82 cases?36.0%?and 52 cases?22.8%?.Nevertheless,the other clinical symptoms,between the two groups,were no significant difference.5.The factors,whether conforms to CAL or not,gender,age,WBC,PLT,CRP,ESR,AST,PCT,PLR,NLR,25-?OH?D3,indicated by the univariate analysis.After multivariate analysis,However,exclude WBC,ESR,AST,PCT,the other variables have significant effect..6.Most of the patients,Coronary artery lesion,of Kawasaki disease would return to normal,opposit,a few CAL occured,the recovery period,which may be related to the patients not having regular follow-up and stopping medication without permission.Conclusions:1.The investigation showed the prevalence of KD was higher in boys than girls,the peak age,under 2 years old,comed to ligh.Gender,Children with KD complicated with CAL,had significant difference,but not in age.2.Bulbar conjunctival congestion,besides fever,was the most common clinical manifestations in children with KD.The incidence,of Acromegaly and perianal desquamation,was higher in CAL group than those in NCAL group,which conjectured be related to the occurrence of CAL..3.The independent risk factors,male,the increase of PLT,CRP,PLR and NLR and the decrease of 25-?OH?D3,indicated by the multivariate analysis.Which,in judging whether KD concurrent CAL or not,onsidered to be significant.4.After standard treatment,most of the children with KD complicated with CAL have a good prognosis.Regular follow-up and medication in accordance with the instructions were conducive to the recovery of CAL and avoid the recurrence of CAL of coronary artery lesion.