Comparative study of coronary artery lesions in complete and incomplete Kawasaki disease
10.3969/j.issn.1000-3606.2018.1.004
- VernacularTitle:完全川崎病和不完全川崎病冠脉病变对比研究
- Author:
Danfeng ZHANG
1
;
Jiarong ZHONG
;
Dan WANG
Author Information
1. 重庆医科大学附属儿童医院礼嘉分院全科病房 儿童发育疾病研究教育部重点实验室 儿童发育重大疾病国家国际科技合作基地 儿科学重庆市重点实验室 重庆 400014
- Keywords:
complete Kawasaki disease;
incomplete Kawasaki disease;
coronary artery disease;
thrombosis
- From:
Journal of Clinical Pediatrics
2018;36(1):14-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the difference of coronary artery lesions (CAL) in complete Kawasaki disease (cKD) and incomplete Kawasaki disease (iKD) in children. Methods The clinical data of 1514 hospitalized children with KD from January 2014 to December 2015 were retrospectively analyzed and compared between the children with cKD and those with iKD. The risk factors of CAL were analyzed. Results There were 1094 cases (72.3％) of cKD and 420 cases (27.7％) of iKD in 1514 children with KD. The incidence of CAL in all KD children was 51.9％. And the incidence of CAL in cKD group and iKD group was 57.2％and 37.9％, respectively, and there was statistical difference (P<0.01). The distribution of different degrees of CAL between cKD group and iKD group was statistically different (P<0.01). The incidence of echo enhancement or small coronary artery aneurysm in cKD group (50.4％) was higher, and the incidence of giant coronary artery aneurysm in iKD group (2.4％) was relatively higher. The incidence of thrombosis in iKD group was 3.3％, which was significantly higher than that in cKD group (0.6％) (P<0.001). The time when CAL was found first by clinical ultrasound echocardiography in cKD group and iKD group were 7.842.97 d and 8.472.89 d, respectively, and there was statistical difference (P<0.05). The most frequent involvement was left main trunk in CAL in children with KD. The proportion of simultaneous involvement of the left and right coronary arteries, only right stem involvement, and whole left coronary artery involvement in were significantly higher cKD group than those in iKD group, while the proportion of left main trunk involvement was significantly higher in iKD group than that in cKD group (all P<0.05). Male and iKD were the high risk factors for CAL, and intravenous infusion of immunoglobulin (IVIG) in 5～10 days of the course of disease was the protective factor for CAL. Conclusions CAL, especially giant coronary artery aneurysms and thrombosis, are more common in children with iKD. In iKD, the left coronary artery is mainly involved in CAL, and in cKD, the simultaneous involvement of left and right coronary arteries is the most common in CAL. Standard use of IVIG can reduce the occurrence of CAL.
