Analysis Of Risk Factors For Kawasaki Disease Complicated By Coronary Artery Lesions

Objective:To summarize and compare the clinical manifestations and laboratory indices of Complete Kawasaki disease(CKD)and Incomplete Kawasaki disease(IKD),to analyze the risk factors for the development of coronary artery lesions(CAL)in children with Kawasaki disease(KD),and to explore the predictive value of inflammatory markers for coronary artery lesions.Methods:1.A total of 75 children with Kawasaki disease admitted to the pediatric department of the Affiliated Hospital of Affiliated Hospital of Guilin Medical College during January 2018-December 2022 were retrospectively analyzed and divided into 52 cases of CKD and 23 cases of IKD according to the diagnostic criteria.Then they were divided into coronary artery lesions group(CAL group)and no coronary artery lesions group(NCAL group)according to the presence or absence of coronary artery lesions.2.The gender,age,blood routine,laboratory index,coronary artery internal diameter value and Z value measured by echocardiography were collected from all children,and calculate the platelet-to-neutrophil ratio(PNR).PNR).3.Statistical analysis of clinical features and laboratory indices was performed using SPSS26.0 statistical software.Results:1.Comparison of clinical characteristics between the CKD group and the IKD group:there were statistically significant differences in skin changes,lip and oral changes,cervical lymph node enlargement,and terminal changes of the extremities between the two groups(P<0.05),and there were no statistically significant differences in gender,age,coronary artery lesions,and bulbar conjunctival congestion between the two groups(P>0.05).2.Comparison of laboratory indexes between CKD group and IKD group:the differences in CRP and ESR between the two groups were statistically significant(P<0.05),and the differences in PNR,PCT,D-D2and CK-MB between the two groups were not statistically significant(P>0.05).3.Comparison of clinical characteristics between CAL group and NCAL group:there were statistically significant differences in skin changes and fever time before using IVIG between the two groups(P<0.05),and there were no statistically significant differences in age,gender,lip and oral changes,bulbar conjunctival congestion,cervical lymph node enlargement,and terminal changes of limbs between the two groups(P>0.05).4.Comparison of laboratory indexes between CAL and NCAL groups:there were statistically significant differences in neutrophil,ALB,PNR,D-D2,and fever time before using IVIG between the two groups(P0.05).5.The area under the ROC curve for neutrophil,ALB,PNR,D-D2,and fever time before using IVIG to predict CAL were 0.686,0.674,0.674,0.790,and 0.670.The best critical values were 10.12×10~9/L,36.05g/L,38.374,1.96ug/ml,and 7.5d.The sensitivity were 75%,90%,75%,60%,50%,and the specificity were 57.3%,47.3%,61.8%,90.9%,78.2%.6.Using the presence or absence of CAL as the dependent variable and ALB,PNR,D-D2 and fever time before using IVIG as covariates.After multi-factor logistic regression analysis,the results showed that PNR and D-D2 were independent risk factors for CAL.7.D-D2 level was positively correlated with the degree of coronary artery dilation in children with KD,(P<0.05).Conclusions:1.The fever time before using IVIG,neutrophil,albumin,PNR and D-D2 predicted the occurrence of coronary artery lesions in children with KD,among which PNR and D-D2 were independent influencing factors of coronary artery lesions in Kawasaki disease.2.D-D2 was positively correlated with the degree of coronary artery dilatation in children with KD.