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 recu-rrent 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%CI 1.01-8.75, P=0.04), duration of fever ≥ 10 d (OR=6.67, 95%CI 1.57-22.54, P=0.01), time of treatment with IVIG ≥7 d(OR=3.57, 95%CI 1.12-11.02, 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.