Coronary artery lesions in infants younger than 6 months with Kawasaki disease: clinical characteristics and prognosis
10.3760/cma.j.issn.1673-4912.2022.03.010
- VernacularTitle:6月龄以下婴儿川崎病冠状动脉病变的临床特征及预后分析
- Author:
Haiyan GE
1
;
Dong QU
;
Shuang LIU
;
Jin ZHANG
;
Li LI
;
Rong MI
Author Information
1. 首都儿科研究所附属儿童医院重症医学科，北京 100020
- Keywords:
Kawasaki disease;
Infant;
Coronary aneurysm;
Z-score
- From:
Chinese Pediatric Emergency Medicine
2022;29(3):206-210
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the characteristics of coronary artery lesions in infants under 6 months of age with Kawasaki disease(KD), and to explore their regression and risk factors.Methods:The clinical data of 61 infants with KD[34 boys, 24 girls, aged 2.2 (1.7, 3.1) months] admitted to the department of critical care medicine and neonatology, Children′s Hospital, Capital Institute of Pediatrics from October 2015 to February 2020 were retrospectively analyzed.Persistent coronary artery aneurysm(CAA)was defined as the persistent enlargement of coronary arteries(coronary Z-score≥2.5)on echocardiograms at 12 months after KD onset.Cox proportional hazards mode was conducted to evaluate the potential risk factors of persistent CAA.Results:The incidence of CAA in 61 infants with KD was 52.5% (32/61) and occurred on 5 (4, 8)d of the disease course.During a follow-up of 547 (399, 782)d, five(8.2%, 5/61)infants satisfied the definition of persistent CAA.The median recovery time of CAA was 20 (12, 82)d after KD onset.Cox proportional hazards mode revealed that the maximal coronary Z-score was an independent factor of CAA regression( HR=0.451, 95% CI 0.293-0.694, P<0.001). Receiver operating characteristic curve analysis showed that the best cutoff value of coronary Z-score for predicting persistent CAA was 6.15(sensitivity 80.0%, specificity 97.7%). Conclusion:CAA is common in infants younger than 6 months with KD.The maximal coronary Z-score is an independent factor of persistent CAA.
