关键词: 川崎病；　再发；　危险因素；　冠状动脉损害

Abstract: 　Objective　To explore the clinical characteristics and risk factors of recurrent Kawasaki disease（KD). Method The clinical characteristics and risk factors of recurrent KD in children admitted between 2010 and 2018 were retrospective analyzed. Results A total of 2112 children with primary KD were admitted during the study period, 35 of whom were recurrent and a recurrence rate of 1.66%. The median time of KD recurrence in 35 children was 13.5 (4~69) months after the first onset of KD. Compared with the children with initial onset, the fever duration in the children with recurrent onset was shorter, the proportion of edema in extremities was lower, the C-reactive protein was increased, and the serum potassium was decreased, and the differences were statistically significant (all P<0.05). Among 35 children with recurrent KD, 11 had coronary artery lesion (CAL) at the initial stage, 8 of whom had CAL again at the time of recurrence. Multivariate logistic regression analysis showed that Mycoplasma pneumoniae infection and the increased proportion of CD19+CD23+ lymphocyte subsets were independent risk factors for KD recurrence (both P<0.05). The ROC curve was drawn based on the recurrence risk score. The area under the curve was 0.84 (95%CI: 0.76~0.91). When the best critical value was 1.24, the sensitivity and specificity were 0.83 and 0.70, respectively. Conclusions　KD children should be followed up for at least 2 years after onset. Mycoplasma pneumoniae infection and elevated CD19+ CD23+ lymphocyte subsets can be used as predictors of KD recurrence. Children who had CAL at the initial onset of KD are also more likely to have CAL at the recurrence of KD.

Key words: Kawasaki disease;　recurrence;　risk factor;　coronary artery lesion