Division of Cardiology, Children's National Medical Center, Washington, DC 20010, USA.
Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC 20010, USA.
Diagnostics (Basel). 2013 Mar 26;3(2):232-43. doi: 10.3390/diagnostics3020232.
Coronary artery involvement is seen in approximately 15-20% of children with Kawasaki disease. There is conflicting literature regarding the clinical and laboratory findings associated with coronary artery involvement. In this retrospective study, we attempt identification of predictive factors for coronary artery involvement at our institute and review the existing literature.
A review of 203 patients (65% males) with Kawasaki disease was performed, of whom 33 (16.3%) had coronary artery involvement. High erythrocyte sedimentation rate, high platelet count, low hematocrit, low albumin levels, and refractory Kawasaki disease showed significant association with coronary artery involvement. High erythrocyte sedimentation rate and refractory Kawasaki disease were found to be independent predictors of coronary artery involvement. Review of literature suggested a wide range of coronary involvement (<5% to >60%), and highly conflicting clinical and laboratory associations.
It remains difficult to accurately determine risk of coronary artery involvement, although some laboratory markers may provide information that is helpful for parental counseling and clinical follow up. Future identification of novel biomarkers and host predispositions may further our understanding of coronary artery risks and help personalize therapy for Kawasaki disease.
约 15-20%的川崎病患儿存在冠状动脉受累。关于与冠状动脉受累相关的临床和实验室发现，文献存在争议。在这项回顾性研究中，我们试图确定本研究所的冠状动脉受累的预测因素，并复习现有文献。
对 203 例（男性占 65%）川崎病患者进行了回顾性分析，其中 33 例（16.3%）存在冠状动脉受累。高红细胞沉降率、高血小板计数、低血细胞比容、低白蛋白水平和难治性川崎病与冠状动脉受累有显著相关性。高红细胞沉降率和难治性川崎病是冠状动脉受累的独立预测因素。文献复习表明，冠状动脉受累范围广泛（<5%至>60%），且临床和实验室相关性存在很大争议。
尽管某些实验室标志物可能提供有助于家长咨询和临床随访的信息，但仍难以准确确定冠状动脉受累的风险。未来对新型生物标志物和宿主易感性的识别可能有助于进一步了解冠状动脉风险，并有助于川崎病的个体化治疗。
