The Department of Cardiology, Children's Hospital of Soochow University, No. 92, Zhongnan Street, Suzhou, 215025, China.
Clin Rheumatol. 2018 Jul;37(7):1945-1951. doi: 10.1007/s10067-018-3977-6. Epub 2018 Jan 12.
Kawasaki disease (KD) is the leading cause of acquired heart disease due to its complicated coronary artery lesions. Up to now, few studies were focused on the status of persistent coronary artery aneurysms (CAA) in KD patients. The present study was designed to identify the coronary artery outcomes and seek the risk factors associated with the regression of CAA in KD patients. One hundred and twenty KD patients with CAA hospitalized in Children's Hospital of Soochow University from Jan 2008 to Dec 2013 were prospectively studied by a 3-year follow-up. Data regarding demographic, clinical, laboratory, and echocardiographic characteristics were documented and further analyzed. It was estimated that 39.2% of the patients had complete regression of CAA within 4 weeks, 59.2% within 8 weeks, and 70.0% within 16 weeks. No fatal cardiac events occurred. We found patients who aged ≤ 1 year, received initial intravenous immunoglobulin (IVIG) treatment after the 10th day of illness, and IVIG non-responders were associated with the regression of persistent CAA. The relative risks were 1.55, 1.87, and 1.88, respectively. Age, initial IVIG treatment, and IVIG response were risk factors of persistent CAA, and more attention should be paid on these patients.
川崎病（KD）是导致后天性心脏病的主要原因，其复杂的冠状动脉病变是其主要特征。到目前为止，很少有研究关注川崎病患者持续性冠状动脉瘤（CAA）的现状。本研究旨在明确川崎病患者的冠状动脉转归，并寻找与 CAA 消退相关的危险因素。
我们前瞻性研究了 2008 年 1 月至 2013 年 12 月在苏州大学附属儿童医院住院的 120 例川崎病合并 CAA 患儿，随访 3 年。记录了患者的人口统计学、临床、实验室和超声心动图特征等数据，并进行了进一步分析。
研究结果显示，约 39.2%的患者在 4 周内完全消退，59.2%在 8 周内消退，70.0%在 16 周内消退。无致命性心脏事件发生。我们发现年龄≤1 岁、发病后第 10 天开始接受初始静脉注射免疫球蛋白（IVIG）治疗以及 IVIG 无反应的患者与持续性 CAA 的消退有关，其相对危险度分别为 1.55、1.87 和 1.88。
年龄、初始 IVIG 治疗和 IVIG 反应是持续性 CAA 的危险因素，应更加关注这些患者。
