Retrospective Analysis On 34 Cases Of Kawasaki Disease Combined With Coronary Artery Thrombosis

Objective: To explore the clinical characteristics of children with Kawasaki disease(KD)complicated with coronary artery thrombosis.Methods: 34 cases of children with Kawasaki disease combined with coronary artery thrombosis admitted and treated in Children’s Hospital of Chong Qing Medical University from January 2012 to December 2018 were retrospectively analyzed,whose clinical presentations,medical history,electrocardiogram,echocardiography were analyzed.Results1.The ratio of male to female in 34 cases of children with Kawasaki disease combined with coronary artery thrombosis was 3.86:1,and the onset age ranged from 0.3 to 10.8(average 3.4±2.8)years old,and 20 cases(58.8%)were incomplete Kawasaki disease.Giant coronary artery aneurysms[37.5%(15/40 branches)]、thrombosis[46.2%(24/52 branches)] often attributed to left anterior descending,medium coronary artery aneurysms[33.3%(18/54branches)]often attributed to left coronary artery.2.Thrombosis[55.8%(29/52branches)] were mostly detected in giant coronary artery aneurysm,of which 17 branches formed multiple thrombosis,and other thrombosis [44.2%(23/52branches)]were detected in medium coronary artery aneurysms,of which 5 branches formed multiple thrombosis;The maximum diameter of giant coronary artery aneurysms [40%(16/40 branches)] were presented within one month,and 4 branches(10%)eventually returned to normal within 21± 7.0(8~34)months.The maximum diameter of medium coronary artery aneurysms [72.7%(39 /54branches)]were presented within one month,and 29 branches(53.7%)eventually returned to normal within11.7± 10.6(0.5~32)months.3.Compared with the favorable prognosis group,children in the unfavorable prognosis group had greater maximum diameter of coronary artery [(12.5 ±3.1)mm vs(7.8 ±2.5)mm],lager number of giant coronary artery aneurysm [(2.3 ±0.9)vs(0.5 ±0.7)],and lager number of thrombosis [(2.0±0.8)vs(1.3 ± 0.6)].Conclusions1.Incomplete KD was more prone to coronary artery damage and thrombosis in acute phase;Children with KD complicated with medium coronary artery aneurysm and giant coronary artery aneurysm were prone to thrombosis in the first month of the disease.2.Medium coronary artery aneurysm with thrombosis recovered mostly within one year,Because of the recurrent and persistent thrombosis,giant coronary artery aneurysm with thrombosis was difficult to recover,long-term follow-up should be maintained.3.Greater maximum diameter of coronary aneurysm,lager number of giant coronary artery aneurysm and thrombosis,the worse the long-term prognosis of children with KD complicated with coronary artery thrombosis.