Objective To provide evidence for timely diagnosis and treatment of Kawasaki disease through assessing the relationship between the duration of fever and the incidence of coronary artery lesion in patients with Kawasaki disease. Methods To retrospectively analyze the clinical information of 352 inpatients with Kawasaki disease (including typical Kawasaki disease, incomplete Kawasaki disease, and non-responsive to intravenous immunoglobulin treatment Kawasaki disease ) from January 1997 to December 2007. The relationship between the duration of fever and the incidence of coronary artery lesion was presented by a linear trend plot, using Cochran-Armitage trend test. A value of P lt; 0.05 was considered statistically significant. Results Among 352 patients with Kawasaki disease, 88 had coronary artery lesions. Sixty-eight out of 294 patients with typical Kawasaki disease, 20 out of 58 patients with incomplete Kawasaki disease, and 18 out of 44 patients with non-responsive Kawasaki disease had coronary artery lesions. Linear trend analysis showed that the duration of fever in all 352 patients with Kawasaki disease and 294 cases with typical Kawasaki disease was positively correlated with the incidence of coronary artery lesion (Plt;0.05). However, in patients with incomplete Kawasaki disease and non-responsive Kawasaki disease, the relationship between the duration of fever and the incidence of coronary artery lesion was not significant (Pgt; 0.05). Conclusion The longer the duration of fever was in patients with Kawasaki disease, higher the risk of coronary artery lesion.
目的 探讨川崎病（Kawasaki disease，KD）患儿血脂代谢与冠状动脉病变之间的关系。 方法 纳入2007年1月-2009年10月住院治疗的82例KD患儿，检测治疗前后血总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、极低密度脂蛋白（VLDL-C）、载脂蛋白A1（ApoA1）及载脂蛋白B100（ApoB100）水平。选取50例健康儿童作为对照。KD患儿在治疗前行超声心动图检查，根据超声心动图显示将KD组再分为冠状动脉病变组（CAL组，n=31）和非冠状动脉病变组（NCAL，n=51）。 结果 治疗前，KD患儿TC、ApoA1、HDLC降低，TG、LDL-C升高，与正常儿童相比有统计学意义（Plt;0.05）。KD患儿CAL组较NCAL组变化更明显，有统计学意义（Plt;0.05）。VLDL-C和ApoB100水平KD患儿与正常儿童比较、NCAL组与CAL组比较变化均不明显（Pgt;0.05）。治疗后与治疗前相比，NCAL组TC、TG、HDL-C、LDL-C、ApoA1恢复正常（Plt;0.05）），而CAL组仅TC、LDL-C、ApoA1恢复正常（Plt;0.05）。 结论 KD患儿存在血脂代谢紊乱，TC、TG、HDL-C、LDL-C、ApoA1与冠状动脉的损害有关，应早期进行干预。
ObjectiveTo systematically review the response of Kawasaki disease (KD) after an initial standard dose of intravenous immunoglobulin (IVIG) therapy and routine laboratory indexes.MethodsWe searched PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases to collect case-control studies about the correlation between response of KD after an initial standard dose of IVIG therapy and routine laboratory indexes till 31st December 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. A meta-analysis was performed by using RevMan 5.3 software.ResultsThirty studies were included. The results of meta-analysis demonstrated that the levels of hemoglobin (Hb) (SMD=–0.21, 95%CI –0.32 to –0.09, P<0.001), serum albumin (ALB) (SMD=–0.68, 95%CI –0.90 to –0.47,P<0.001) and serum sodium (SMD=–0.64, 95%CI –1.01 to –0.27,P<0.001) in IVIG non-responsiveness group were significantly lower than those in IVIG responsiveness group. The levels of alanine aminotransferase (ALT) (SMD=0.74, 95%CI 0.36 to 1.13,P<0.001), aspartate aminotransferase (AST) (SMD=0.61, 95%CI 0.24 to 0.99,P=0.001) and C-reactive protein (CRP) (SMD=0.63, 95%CI 0.38 to 0.87, P<0.001) in IVIG non-responsiveness group were higher than those in the IVIG responsiveness group.ConclusionThe current evidence shows that low levels of Hb, ALB and serum sodium and high levels of CRP, ALT, and AST are risk factors of IVIG non- responsiveness in KD. Due to limited quality and quantity of included studies, more high-quality studies are needed to verify the conclusion.
Objective To analysis the research status and hotspot in the field of Kawasaki disease (KD) in recent 10 years. Methods The relevant documents included in the core database of Web of Science from 2010 to 2021 were searched, to analyze the cooperation relationship among authors, countries and institutions by CiteSpace software, analyze the co-occurrence, cluster analysis, dynamic frontier evolution and emergence of keywords, analyze the co citation of cited journals and documents, draw a visual map and analyze. Result A total of 3 041 articles were included, and there were 114 core authors. USA was the core country in the research field of KD, while China occupied a place. University of California, San Diego and Montreal University were the core research institutions. Circulation was the core journal. Keywords formed 7 clusters, and there were a total of 62 emergent words. Conclusions In the past 10 years, the research on KD has shown an upward trend. The research hot spots focus on the diagnosis and treatment, management, pathogenesis, epidemiological research of KD, and the research on Kawasaki-like diseases during the coronavirus disease 2019. Predicting the long-term management of KD, related research on intravenous immunoglobulin resistance and cytokines are the research frontiers in this field.