Abstract: Objective　To explore the change and clinical significance of red blood cell distribution width (RDW) in children with Kawasaki disease (KD). Methods　A total of 185 hospitalized children newly diagnosed with KD from January 2014 to May 2019 were selected. According to the results of echocardiography before treatment, patients were divided into coronary artery lesion group (CAL group, 24 cases) and non-coronary artery lesions group (nCAL group, 161 cases). And another 50 healthy children in the same period were selected as the control group. The differences of RDW, white blood cell count (WBC), platelet count (PLT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), alanine aminotransferase (ALT), and albumin (ALB) levels among groups were compared. The independent risk factors of KD combined with CAL were screened by multiple logistic regression analysis. The efficacy of RDW in predicting KD combined with CAL in acute phase was analyzed by receiver operating characteristic (ROC) curve. Results　The levels of RDW, WBC, PLT, ESR, CRP, and ALT in KD group were higher than those in the control group, and the levels of ALB in KD group were lower than those in the control group (all P<0.05). The differences of RDW, WBC, CRP, ALB, and fever duration between CAL group and nCAL group were statistically significant (all P<0.05). Multiple logistic regression analysis showed that RDW, WBC, CRP, ALB, and fever duration were all influencing factors of CAL occurrence, and RDW was positively correlated with WBC and CRP levels and negatively correlated with ALB levels. The sensitivity and specificity of RDW≥13.35% were 87.5% and 68.3% in predicting KD with CAL respectively, and the area under the ROC curve (AUC) was 0.827 (95% CI: 0.749~0.905, P<0.001). Conclusions　The changes of RDW level can be used as one of the important indexes for early prediction of CAL in KD children.

Key words: Kawasaki disease;　red blood cell distribution width;　coronary artery lesion