Correlation Analysis Between Different Feeding Methods Of Infants And Coronary Artery Lesion In Kawasaki Disease

OBJECTIVE:To analyze the clinical manifestations,laboratory examinations,electrocardiogram,echocardiogram,etc.of children with Complete Kawasaki disease(CKD)and Incomplete Kawasaki disease(IKD)who received different feeding methods in infancy,the correlation between different feeding methods and clinical characteristics and coronary artery lesion of Kawasaki disease was preliminarily explored.Methods:The KD data of 709 infants(0-3 years old)hospitalized in children’s Hospital Affiliated to Suzhou University from May 2016 to August 2019 were collected(including 567 children with CKD and 142 children with IKD).According to the different feeding methods,they were divided into three groups:breast feeding group(320 cases),mixed feeding group(236 cases)and artificial feeding group(153 cases).They were analyzed retrospectively.The collected children’s gender,age,contact information,breastfeeding after birth,start and stop time of breastfeeding,when to add milk powder,previous allergy information,cardiac follow-up after discharge and laboratory test results were entered into an Excel table,and spss21.0 software was used for data statistical analysis,with a=0.05 as the test level of inter group comparison.For descriptive statistics,measurement data is expressed as mean±standard deviation,and classification data is expressed as number of cases and percentage(%).The selection of statistical methods is as follows:(1)For comparison of measurement data between two groups,two-sample T-test was used.(2)Measurement data were compared between groups using the variance F test,and pair-wise comparisons within groups were performed using the LSD-T method.(3)Nonparametric rank sum test was used for comparison between grade data sets.(4)Single factor Logistic regression was used to analyze the influencing factors of indicators.Multivariate correlation analysis was performed using binary Logistic regression model,in which univariate factors were evaluated as significant factors and were represented by adjusted Odds Ratios(OR)and 95%Confidence Interval(CI).Results:(1)Basic information:The composition ratio of different feeding methods of children in CKD and IKD groups was similar,with no statistical difference(P>0.05).Breast feeding children with CKD were lower in male ratio and allergy incidence than the mixed feeding and artificial feeding groups(P<0.05).The incidence of allergy in children with IKD who were breast feeding was lower than that in the mixed feeding and artificial feeding groups(P<0.05).(2)Clinical manifestations:The fever days of CKD children with artificial feeding were significantly higher than breast-feeding group(P<0.05).The incidence of strawberry tongue in breast feeding children with IKD was significantly lower than that in the mixed and artificial feeding groups(P<0.05).(3)Laboratory examination:Among breast feeding children with CKD,albumin,IgG and CD3-CD(16+56)+were higher than those in the mixed feeding and artificial feeding groups,and the difference was statistically significant(P<0.05).The IgA of artificially feeding children with CKD was higher than that of the mixed feeding and breast feeding groups,and the difference was statistically significant(P<0.05).IgG,CD3+CD4+and CD3+CD8+in breast feeding children with IKD were higher than those in mixed and artificial feeding groups.IgM in the mixed feeding group was significantly higher than that in the breast feeding and artificial feeding groups,and the difference was statistically significant(P<0.05).(4)ECG examination:There was no statistical difference between the three feeding methods in the ECG abnormalities of children with CKD and IKD(P>0.05).(5)Ultrasound imaging:In both children with CKD and IKD,the incidence and grade of CAL in the breast feeding group were lower than artificial feeding group(P<0.05).Binary Logistic regression analysis confirmed that different feeding methods in infants and young children are related to coronary artery damage in Kawasaki disease;after adjusting for age and gender factors,the correlation still exists.Conclusion:(1)The proportions of breast feeding,artificial feeding and mixed feeding in CKD and IKD groups were similar.(2)The incidence of coronary artery damage and the level of CAL in breast feeding children with KD were lower than that of artificial and mixed feeding.