Zhang Lunmin,Peng Yue,Su Jianjun,et al.Risk factors for Kawasaki disease comorbid with coronary artery lesion: a multicenter retrospective study[J].Journal of Chongqing Medical University,2025,50(1):94-97.
Zhang Lunmin,Peng Yue,Su Jianjun,et al.Risk factors for Kawasaki disease comorbid with coronary artery lesion: a multicenter retrospective study[J].Journal of Chongqing Medical University,2025,50(1):94-97. DOI: 10.13406/j.cnki.cyxb.003662.
Risk factors for Kawasaki disease comorbid with coronary artery lesion: a multicenter retrospective study
To investigate the risk factors for Kawasaki disease(KD) comorbid with coronary artery lesion(CAL) by analyzing the clinical features and laboratory markers of children with KD.
Methods
2
A total of 346 children with KD who were hospitalized for treatment from June 2023 to June 2024 were enrolled as subjects,among whom there were 134 children from The First People’s Hospital of Zunyi and 212 children from Children’s Hospital of Chongqing Medical University. According to the presence or absence of CAL,the children were divided into KD group with CAL(KD-CAL group) and KD group without CAL(KD-NCAL group). A difference analysis,a collinearity analysis,and the multivariate logistic regression analysis were performed for the clinical features and laboratory markers of the two groups.
Results
2
There were no significant differences between the KD-CAL group and the KD-NCAL group in age,time of intravenous immunoglobulin shock therapy,rash,lip changes,bulbar conjunctival hyperemia,peripheral changes of limbs,white blood cell count,hemoglobin,percentage of neutrophils,platelet count,C-reactive protein,erythrocyte sedimentation rate,alanine aminotransferase,and blood sodium(
P
>
0.05),while there were significant differences between the two groups in sex,cervical lymphadenectasis,procalcitonin(PCT),and albumin(ALB)(
P
<
0.05). The subsequent multivariate logistic regression analysis showed that male sex(odds ratio[
OR
]=1.886,95%CI=1.198-2.971,
P
=0.006),ALB(
OR
=0.938,95%CI=0.894-0.983,
P
=0.008),and PCT(
OR
=1.107,95%CI=1.007-1.207,
P
=0.035) were independently associated with the presence of CAL in patients with KD.
Conclusion
2
Male sex,low ALB,and high PCT are independent risk factors for CAL in children with KD,and for such children,early intervention should be actively performed to avoid CAL.
关键词
Keywords
references
Kuo HC . Diagnosis,progress,and treatment update of Kawasaki disease [J ] . Int J Mol Sci , 2023 , 24 ( 18 ): 13948 .
McCrindle BW , Li JS , Minich LL , et al . Coronary artery involvement in children with Kawasaki disease:risk factors from analysis of serial normalized measurements [J ] . Circulation , 2007 , 116 ( 2 ): 174 - 179 .
Zhou CZ , Song SR , Chen LQ , et al . Risk factors analysis of coronary artery aneurysm occurrence in children with Kawasaki disease [J ] . J Clin Pediatr , 2023 , 41 ( 7 ): 498 - 501,518 .
Holve TJ , Patel A , Chau Q , et al . Long-term cardiovascular outcomes in survivors of Kawasaki disease [J ] . Pediatrics , 2014 , 133 ( 2 ): e305 - e311 .
Lin MT , Sun LC , Wu ET , et al . Acute and late coronary outcomes in 1073 patients with Kawasaki disease with and without intravenous γ-immunoglobulin therapy [J ] . Arch Dis Child , 2015 , 100 ( 6 ): 542 - 547 .
Jakob A , von Kries R , Horstmann J , et al . Failure to predict high-risk Kawasaki disease patients in a population-based study cohort in Germany [J ] . Pediatr Infect Dis J , 2018 , 37 ( 9 ): 850 - 855 .
McCrindle BW , Rowley AH , Newburger JW , et al . Diagnosis,treatment,and long-term management of Kawasaki disease:a scientific statement for health professionals from the American heart association [J ] . Circulation , 2017 , 135 ( 17 ): e927 - e999 .
Mavrogeni S , Papadopoulos G , Hussain T , et al . The emerging role of cardiovascular magnetic resonance in the evaluation of Kawasaki disease [J ] . Int J Cardiovasc Imaging , 2013 , 29 ( 8 ): 1787 - 1798 .
Xia YH , Qiu HX , Wen ZW , et al . Albumin level and progression of coronary artery lesions in Kawasaki disease:a retrospective cohort study [J ] . Front Pediatr , 2022 , 10 : 947059 .
Tai IH , Wu PL , Guo MM , et al . Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease [J ] . BMC Pediatr , 2020 , 20 ( 1 ): 203 .
Dominguez SR , Martin B , Heizer H , et al . Procalcitonin (PCT) and Kawasaki disease:does PCT correlate with IVIG-resistant disease,admission to the intensive care unit,or development of coronary artery lesions? [J ] . J Pediatric Infect Dis Soc , 2016 , 5 ( 3 ): 297 - 302 .
Pan Y , Fan Q . The role of procalcitonin for predicting Kawasaki disease [J ] . Fetal Pediatr Pathol , 2022 , 41 ( 6 ): 1015 - 1022 .
Miyata K , Miura M , Kaneko T , et al . Risk factors of coronary artery abnormalities and resistance to intravenous immunoglobulin plus corticosteroid therapy in severe Kawasaki disease:an analysis of post RAISE [J ] . Circ Cardiovasc Qual Outcomes , 2021 , 14 ( 2 ): e007191 .
Iio K , Morikawa Y , Miyata K , et al . Risk factors of coronary artery aneurysms in Kawasaki disease with a low risk of intravenous immunoglobulin resistance:an analysis of PostRAISE [J ] . J Pediatr , 2022 , 240 : 158 - 163 . e4.
Tang YJ , Ding CX , Xu QQ , et al . Prediction nomogram for coronary artery aneurysms at one month in Kawasaki disease [J ] . Ital J Pediatr , 2023 , 49 ( 1 ): 146 .