Clinical Analysis Of 61 Cases Of Kawasaki Disease

Objective: To understand the incidence,clinical features of Kawasaki disease（KD）through clinical prospective analysis.To compare the clinical characters of typical and incomplete KD.To compare the therapeutic effect of different dose method of intravenous immune globulin（IVIG）,and coronary artery lesion（CAL）caused by KD.Methods: Clinical data of 61 cases with Kawasaki disease who were hospitalized in Department of Pediatrics,the First Affiliated Hospital of Dali University,from November 2017 to December 2019,were collected.Recording the onset,season,ages,sex,clinical manifestation,ultrasonic cardiography（USG）,electrocardiogram（ECG）,thoracic roentgenoscopy,routine blood test,C-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）,aspartate aminotransferase（AST）,albumin（ALB）,creatine phosphokinase isoenzyme（CK-MB）,hemoculture,ant-mycoplasma pneumoniae（MP-Ig M）,routine urine test,etc.analysis through statistics:（1）.Clinical features of 61 cases with KD were summarized;（2）.Clinical characters of typical and incomplete KD were compared;（3）.The risk factors of coronary artery lesion（CAL）;（4）.Therapeutic effect of three different dose and methods of IVIG were compared.Results:（1）61 cases with KD were more common in children under 5years old（77.04%）,and less than 3 years old（57.4%）were more common.The incidence rate of boys was higher（male: female 1.6:1）,and they could be found all the year –round.But they more in summer and autumn（accounted 64%）;（2）Incomplete KD is more common in infants in less than 1year old,had low prevalence of all major clinical manifestation than those of typical cases（P,0.05 or 0.01）,and had prolonged fever duration before being diagnosed.As compared with the typical KD,it had markedly higher incidence of CAL（P<0.01）;（3）It was also analyzed that age under three years was risk factor CAL in Kawasaki disease;（4）In comparison of three different IVIG dosage methods on the pyretolysis time and therapeutic reaction,1g/kgx1 d and 1g/kgx2 d were superior to 400mg/kgx5 d,but there had no difference between 1g/kgx1 d and 1g/kgx2d（P>0.05）;（5）the young age,long duration fever was the risk factor and dose and methods of IVIG were protective factor.Conclusion:（1）KD is more common in boys under 5 years old,with a higher incidence in summer and autumn;（2）Incomplete KD,which infants are susceptible to,has lower incidence of all major clinical manifestation than those of typical KD,and has prolonged fever duration before being diagnosed,but markedly higher incidence of CAL;（3）Age less than 3 years old is a risk factor of KD combined with CAL;（4）In term of antipyretic time and therapeutic reaction,1g/kg x1 d was more economic and effective treatment option of IVIG;（5）the fever duration and dose methods of IVIG were independent related factor of no response to the initial treatment of IVIG.