Clinical Analyosis On Coronary Artery Lesions And Recurrence With Kawasaki Disease

Part one Clinical analysis on coronary artery lesions with kawasaki diseaseObjective:To analyze and discuss the risk factors of kawasaki disease complicated with coronary artery lesions,to guide diagnosis and clinical treatment and improve prognosis.Method:Retrospective analysis was performed on clinical data of the 524 hospitalized children with KD from January 2018 to December 2019 in the affiliated Children's Hospital of Suzhou University.Compared the coronary artery lesions group with the non-coronary artery lesions group.Results:1.Among the 524 children with kawasaki disease,433 were in the non-coronary artery lesions group and 91 were in the coronary artery lesions group,70 were males,21 were females,males were 3.33 times as females.2.Compared the coronary artery lesions group with the non-coronary artery lesions group,the results showed that age<1 years,male,the time of initial use of IVIG was>10 days,the total fever duration was ? 10 days,hematocrit,hemoglobin<100g/L,albumin<35g/L,C-reactive protein>100mg/L,C3,C4,CD3+CD4+,CD4+/CD8+CD3+were significantly different(P<0.05).3.The results analyzed by multiple logistic regression analysis showed male[OR=2.484,95%CI(1.361-4.536),P=0.003],the total fever duration was?10days[OR=3.026,95%CI(1.477-6.200),P=0.002],hemoglobin<100g/L[OR=4.998,95%CI(2.706-9.231),P=0.001],CRP>100mg/L[OR=1.819,95%CI(1.021-3.241),P=0.042],albumin<35g/L[0 R=1.907,95%CI(1.001-3.632),P=0.049],were the independent risk factors for CAL(P<0.05).Conclusion:The factors of male,the total fever duration was?10days,hemoglobin<100g/L,CRP>100mg/L,albumin<35g/L,were the independent risk factors for CAL.The total fever duration was?10days was ralated with the severity of CALPart two Clinical analysis on recurrence with kawasaki diseaseObjective:To analyze and discuss the clinical characteristics and risk factors of kawasaki disease recurrence,to guide diagnosis and clinical treatment and improve prognosisMethod:33 recurrent KD patients clinical data during January 2016 and December 2019 in the affiliated Children's Hospital of Suzhou University were retrospectively studied and compared with their initial onset.And selected randomly 33 KD patients without recurrence in the affiliated Children's Hospital of Suzhou University as case control group,to study the clinical features of kawasaki disease recurrence and the risk factors associated with recurrenceResults:1.In the 33 recurrent KD cases males were 2.3 times as females,The age under three in the newly diagnosed group accounts for 87.88%,the median age is 1.58.The age from one to five in the relapsed-refractory group accounts for 81.81%,the median age is 3.33 KD relapsed 0.25 to 5.42 years(average 1.52 years)after the first onset.The total fever duration was remarkably longer in newly diagnosed group(P<0.05)2.Coronary artery diameter Z scores between the control group and the newly diagnosed group was no statistical difference(P>0.05)3.The results analyzed by multiple Logistic regression analysis showed that,before intravenous immunoglobulin(IVIG)treatment,increased ESR[OR=1.037,95%C1(1.004-1.071),P=0.027]and increased LDH[OR=1.015,95%C1(1.007-1.023),P=0.001]were the independent risk factors of KD recurrence.Conclusion:Children with recurrent kawasaki disease are generally under 3 years old at the time of initial onset,and relapse is usually around 1.5 years old.The total fever duration was remarkably longer in newly diagnosed KD.CAL is not the independent risk factors for KD recurrence.Before intravenous immunoglobulin(IVIG)treatment,increased ESR and LDH were the independent risk factors of KD recurrence.