Risk factors for coronary artery aneurysms in children with Kawasaki disease / 中国医师杂志

ABSTRACT

Objective To explore risk factors for coronary artery aneurysms (CAA) in children with Kawasaki disease (KD),and reduce the rate of serious sequelae of cardiovascular diseases.Methods All the patients were diagnosed as KD in Children’s Hospital Affiliated to Medical College of Zhejiang University from January 2009 to January 2014.A total of 679 cases was included,and 42 with concurrent CAA,181 with concurrent coronary artery expansion (CAD),and 456 without coronary artery damage cases (non-coronary artery lesion,NCAL).Coronary artery damage was related to factors such as gender,age,fever,white blood cell count (WBC),hemoglobin (Hb),platelet count (PLT),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),alanine aminotransferase,serum potassium,plasma amino terminal brain natriuretic peptide precursor (NT-proBNP),and acrylic ball resistance.SPSS 18.0 software package was used for risk factor analysis.Qualitative data using chi-square test,was used to analyze the high risk factors of CAA group,and logistic multivariate regression analysis was also used.Results Chi-square test showed that male,with febrile days ＞ 14 d,NT-proBNP ≥ 1 000 ng/L,immunoglobulin resistance was more likely to have KD concurrent CAA (P ＜ 0.05).Multiple Logistic regression analysis showed that male [OR =4.092,95％ CI (1.514,11.060),P =0.004],febrile days ＞14 d [OR =12.436,95％ CI (4.599,33.631),P =0.000],NT-proBNP≥ 1 000 ng/L [OR =3.305,95％ CI (1.401,7.794),P =0.005],and immunoglobulin resistance [OR =3.842,95 ％ CI (1.562,9.453),P =0.000] were independent risk factors for KD concurrent CAA.Conclusions Male children,febrile days ＞ 14 d,NT-proBNP≥ 1 000 ng/L,and immunoglobulin resistance were independent risk factors of CAA.