Relationship Between Serious Infection And 271 Kawasaki Diseases' Etiopathogenisis And Prognosis

Objective: To find the relationship between the serious infection and Kawasaki disease's etiopathogenisis and prognosis.Methods: From Jun. 2001 to Jan. 2008, we retrospective reviewed the clinical records of 271 Kawasaki disease's patients, who had been in fever for less than 7 days, and all of whom are consistented with the Kawasaki disease's diagnosis standard (amended in the third national Kawasaki disease conference. There are 177 boys and 94 girls in our record , and the ratio is 1.88:1. We devided all the patients into two groups: serious infection group and non-serious infection group (refer to the pediatric danger forked method, which was made in the forth emergency medicine seminar, on May.1995). There are 73 patients in the serious infection group and 198 ones in the non-serious infection group. All these patients were given IVIG 400 mg /(kg.d) intervenous drop infusion for five days. At the same time ,they were given asprin 30 mg /(kg.d) per os, 3 times a day, which was declined to 5 mg /(kg.d) when the patients's temperature was normal. We retrospective reviewed and analyzied the clinical records of age,sex,HCT,PLT,serabumin,ESO,CRP,the number of CAL. Result: From Jun. 2001 to Jan. 2008, we retrospective reviewed the clinical records of 271 Kawasaki disease's patients, who had been in fever for less than 7 days. 73 patients in them are serious infection ones, as the ratio is 27%. The age or sex are no statistically significant between two groups (P>0.05), but the HCT,serabumin of serious infection group are obviously lower than the ones in non-serious infection group, while the ESO and CRP of serious infection group are obriously higher than the other ones(P<0.05). After 36 hous treated by the IVIG, 57 patients(78%) in serious infection group got pyretolysis, as the non-serious infection group has 185 ones (93%). This result has the statistical significance (X2=13.155,P<0.05). By the 1-6 months follow-up, we find 41(57%) patients in the serious infection group has the CAL, as another group has 90(45%) ones.This difference has no statistically significant (X2=2.450, P>0.05). 6 months later, 8 (11%) patients in the serious group has the CAL, as 8(4%) patients in another group. The difference between two groups has the statustucak significance (X2=4.595,P<0.05).Conclusion: 1): The serious infection patients in the KD are obrious more than the ones in health children, so serious infection may be one etiopathogenisis of the KD. 2): The HCT,serabumin of serious infection group are obviously lower than the ones in non-serious infection group, as the ESO and CRP of serious infection group are obriously higher than the other ones, so maybe the serious infection can be the indicatrix of the KD. 3): Less patients in serious infection group got pyretolysis after 36 hous treated by the IVIG, while more patients in the serious group has the CAL6 months later, so the maybe serious infection can degrade the therapeutic efficacy and cause the CAL. As the result, we must pay more attention to the KD patients who has the serious infection.