Analysis on high risk factors for early coronary artery aneurysms early complicated with Kawasaki disease in inpatients by single-center analysis for 6 years / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the high risk factors for early coronary artery aneurysms (CAA)early complicated with Kawasaki disease (KD) in inpatient children.Methods Totally 679 inpatient children with KD from January 2005 to December 2011 in Children's Hospital of Chongqing Medical University were enrolled in this study.These data were analyzed by Chi-square test to analyze the possible risk factors for CAA.Multiple Logistic regression analysis was performed to estimate the OR and 95％ CI for the risk factors.Results There were 385 (56.70％) male and 294(43.30％) female cases with the onset ages of 2 months to 15 years and 7 months.There were 32 cases (4.71％) of CAA,among them,8 cases resistant to intravenous immunoglobulin (IVIG).In total 32 cases of CAA,25 cases were treated with 2 g/(kg · time) IVIG for 1 to 3 times,and 2 cases were also treated by methylprednisolone.The other 7 cases of CAA were treated with IVIG less than or equal to 1 g/(kg · time) for 4 to 7 times.There were 6 recurrent KD cases (0.88％),occurred on the 2nd-18th month after the onset of the illness,including 1 case complicated with CAA.There was no death case during the acute stage.The monofactor analysis showed that male,duration of fever ≥ 10 d,time of treatment with IVIG ≥7 d,hemoglobin＜ 100 g/L,erythrocyte sedimentation rate ≥ 100 mm/1 h,serum albumin ＜ 30 g/L were associated with early complicated CAA (all P ＜ 0.05).However,the age,white blood cells,platelets,C-reactive protein were not associated with early complicated CAA (all P ＞ 0.05).The multiple Logistic regression analysis showed that hemoglobin ＜ 100 g/L (OR =2.99,95％ CI1.01-8.75,P =0.04),duration of fever ≥ 10 d (OR =6.67,95 ％ CI1.57-22.54,P =0.01),time of treatment with IVIG ≥ 7 d (OR =3.57,95 ％ CI1.12-11.02,P =0.02) were the independent risk factors for CAA.Conclusions The levels of hemoglobin ＜100 g/L,duration of fever ≥ 10 d and time of treatment of IVIG ≥7 d are the independent risk factors for CAA.