Study Of Epidemiological Characteristics And Risk Factors Of Coronary Artery Lesion Of Admitted Children With Kawasaki Disease

Objective To describe the epidemiological and clinical characteristics of KD.To investigate the risk factors on children with coronary artery lesion(CAL)secondary to Kawasaki disease (KD).Method Medical record with a KD diagnosis among patients＜18 years of age in four hospitals(Shanxi Province Children's Hospital,the First People's Hospital of Jinzhong,the Third People's Hospital of Datong and Yuncheng Central Hospital)from January 2000 to December 2004,which lie in central,north and south region of Shanxi province separately,were reviewed.Relative information about patients were filled in the unified questionnaire forms and analyzed with the software of SPSS11.5.All cases with or without CAL were analyzed by case-control study,and Logistic regression analysis for 15 influence factors of CAL was made.Results(1)During the study period 487 hospitalizations associated with KD were recorded in the four hospitals of Shanxi province.There are 73 cases in 2000,80 cases in 2001, 107 cases in 2002,87 cases in 2003,140 cases in 2004.The age onset ranged from 54 days to 16 years of age;the age peak was between 1 and 2 years old,that is,the second year after birth. 425(87.3%)occurred among children＜5 years of age,230(47.2%)occurred among children＜2 years of age.The male-to-female ratio was 1.74:1.331(68%)are classic Kawasaki disease; 156(32%)are atypical Kawasaki disease.The disease occurred more frequently in summer and winter and less frequently in autumn.The peak of onset between male and female is discordant: the peak for male lied in May and June(between spring and summer);while the peak for female lied in December and January(winter).The nadir of onset between male and female is coincide, which lied in April and October.458(94%)patients received the examination of ultrasound cardiogram(UCG)within 1 month after the onset.The incidence rate of CAL was 35.6%,the incidence rate of coronary artery aneurysms(CAA,≥4mm in diameter)was 7.4%,the incidence rate of giant coronary artery aneurysms(GCAA,≥8mm in diameter)was 0.66%.No death case was reported among hospitalized children.The recurrence rate was 2.3%.(2)univariate analysis indicated that the fever duration before hospitalization,the total fever duration,platelet(PLT), erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)was closely associated with CAL secondary to KD(P＜0.05 or P＜0.01).Multivariate Logistic regression analysis indicated that age＜1 year old,the total fever duration(＞10days)and elevated CRP were independently correlated with CAL secondary to KD.Conclusion(1)Cases of KD are increasing year by year.The age and gender distribution are similar with those in previous reports,but the seasonal distribution is different.The incidence rate of CAL is higher,while the incidence rate of CAA is lower.The recurrence rate is low.(2) age＜1 year old,the total fever duration(＞10days)and elevated CRP are the high-risk factors of CAL in KD.