Garrido-García Luis M, Morán-Villaseñor Edna, Yamazaki-Nakashimada Marco A, Cravioto Patricia, Galván Fernando
1Cardiology Department,National Institute of Paediatrics,Mexico City,Mexico.
2Dermatology Department,National Institute of Paediatrics,Mexico City,Mexico.
Cardiol Young. 2018 Mar;28(3):386-390. doi: 10.1017/S1047951117001470. Epub 2017 Aug 29.
One of the most important complications of Kawasaki disease is the development of giant coronary aneurysms. Risk factors for their development are still not clear.
A retrospective analysis was conducted at the National Institute of Paediatrics in Mexico City, Mexico. It included all patients with a diagnosis of acute Kawasaki disease between August, 1995 and August, 2015. Clinical and laboratory findings, as well as echocardiographic measurements, were recorded. Patients with giant coronary aneurysms (z-score⩾10) were compared with the rest of the patients. A value of p<0.05 was considered statistically significant. Odds ratios and their 95% confidence intervals were calculated to define risk factors.
During the study period, 416 patients were diagnosed with Kawasaki disease. Of them, 34 developed giant coronary aneurysms during the acute stage of the disease. In the multivariate analysis, patients younger than 1 year, those with a higher duration of illness at the time of diagnosis, and those who received additional intravenous immunoglobulin showed a significantly higher frequency of giant coronary aneurysms.
One of the main factors associated with the development of giant coronary aneurysms was the delay in the diagnosis of Kawasaki disease. This finding highlights the importance of maintaining a high suspicion of the disease, which would enable an early diagnosis and prompt treatment and decrease the risk for developing giant coronary aneurysms.
川崎病最重要的并发症之一是巨大冠状动脉瘤的形成。其形成的危险因素仍不明确。
在墨西哥城的墨西哥国立儿科学会进行了一项回顾性分析。纳入了1995年8月至2015年8月期间所有诊断为急性川崎病的患者。记录临床和实验室检查结果以及超声心动图测量数据。将患有巨大冠状动脉瘤（z评分⩾10）的患者与其他患者进行比较。p值<0.05被认为具有统计学意义。计算比值比及其95%置信区间以确定危险因素。
在研究期间，416例患者被诊断为川崎病。其中，34例在疾病急性期出现了巨大冠状动脉瘤。在多变量分析中，年龄小于1岁的患者、诊断时病程较长的患者以及接受额外静脉注射免疫球蛋白的患者出现巨大冠状动脉瘤的频率显著更高。
与巨大冠状动脉瘤形成相关的主要因素之一是川崎病诊断延迟。这一发现凸显了保持对该病高度怀疑的重要性，这将有助于早期诊断和及时治疗，并降低发生巨大冠状动脉瘤的风险。
