关键词: 川崎病；　冠状动脉损害；　危险因素；　儿童

Abstract: 　Objective　To explore the risk factors of coronary artery lesion (CAL) in Kawasaki disease (KD). Methods　The clinical data of KD in 110 children were analyzed retrospectively. According to the results of color Doppler echocardiography, they were divided into two groups: coronary injury group (CAL group, 40 cases) and non-coronary injury group (NCAL group, 70 cases). Results　The median age at KD onset in 110 children (67 males and 43 females) was 1.58 years old (0.92~3.00 years). There were significant differences in the age distribution and the proportions of atypical KD and fever duration> 6 days before intravenous IVIG between CAL group and NCAL group, and the difference were statistically significant (both P<0.05). The levels of C-reactive protein (CRP), interleukin-6 (IL-6), N-terminal brain natriuretic peptide precursor (NTproBNP) and white blood cells count (WBC) in the CAL group were significantly higher than those in the NCAL group (all P<0.05). The area under ROC curve (AUC) predicted by the duration of fever before IVIG, WBC, IL-6, and pro-BNP was 0.97, 0.69, 0.76, and 0.87 respectively in CAL group. The optimal thresholds were 6.5 days, 19.85×109/L, 92.19 pg/mL, and 1122.5 pg/ mL respectively. The sensitivity of predicting CAL in KD was 84.6%, 46.2%, 100%, and 100%, and the specificity was 91.4%, 91.4%, 57.1%, and 71.4% respectively. Conclusion　Age<3 years, fever duration before IVIG > 6.5 days, atypical KD, and significantly increased WBC, IL-6, and NT proBNP were risk factors for the occurrence of CAL in KD.

Key words: 　Kawasaki disease;　coronary artery damage;　risk factor;　child