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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.
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Objective;To compare and assess the curative effects, starting time and side effects of cardioversion drugs used for treatment of paroxysmal supra - ventricular tachycardia ( PSVT) , including adenosine triphosphate ( ATP) , dofetilide, and cedilanid. Methods; The data of 40 admitted children with PSVT treated with ATP, dofetilide and cedilanid in recent 5 years were collected. The cardioversion time, success rate and side effects of the drugs were compared. The constituent ratio was determined with check x2. Significant level a was 0.05. Results: In group ATP, 89.47% of patients were interrupted; 63. 15% of them had side effects; the cardioversion time of ATP was 3-30 seconds. In group dofetilide, 72.73% the patients were interrupted; 9.09% of them had side effects; the cardioversion time of dofetilide was 5- 30min. In group cedilanid, 61. 11% the patients were interrupted; 5. 55% of them had side effects; the cardioversion time of dofetilide was 20min -5h. Conclusion; ATP should be considered the drug of first choice for PSVT in children without organic heart diseases and serious complication and it has only minor and transient side effects. Dofetilide is equally effective in interrupting PSVT, and has minor side effects, which should be considered the first choice and best suitable for atrioventric-ular reentrant tachycardia. Cedilanid should be considered the drug of first choice for PSVT in children with serious heart failure, and it has a synergic effect to ATP and dofetilide.
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Objective:To study the clinical features of infectious mononucleosis synsdrome due to mycoplasma pneumoniae in children.Methods:5 children with MP-IgM(+),PCR MP-DNA(+),EBV-IgM(-),CMV-IgM(-),HHV-IgM(-),EBV-DNA(-) were analyzed.All patients were diagnosed as infectious mononucleosis due to mycoplasma pneumoniae.Results:All the patients(100%) had fever,enlarged lymph nodes,angina and liver tumefaction.2 cases had spleen tumefaction;5 case had cough;2 cases had nasal obstruction and swollen blepharon;1 case had enlarged parotid gland and skin eruption,and 2 cases had pneumonia and myocarditis.4 cases were cured with azithromycin,and 1 case were cured with abomacetin for 2 weeks.Conclusion:Mycoplasma pneumoniae can lead to infectious mononucleosis syndrome.The main clinical features include irregular fever,angina,enlarged lymph nodes and hepatosplenomegaly.Azithromycin and abomacetin are effective for therapy.