Shengjing Hospital of China Medical University, Shenyang, China.
Eur J Pediatr. 2022 Mar;181(3):951-957. doi: 10.1007/s00431-021-04291-w. Epub 2021 Oct 14.
This study aimed to explore the incidence and clinical characteristics of multiple complications in children with Kawasaki disease (KD). All patients were diagnosed in our hospital between January 2016 and December 2020. A total of 640 cases were included, 43 patients had coronary artery aneurysm, 51 patients had coronary artery dilation, and 546 patients had no coronary artery damage. The patients were divided into three subgroups based on age: < 1 year old, 1-5 years old, and > 5 years old. The multiple complications of all the KD children and the correlation between extracardiac complications and cardiovascular complications were analyzed. Among the 640 KD children, most were 1-5 years old (415/640, 64.8%). Children < 1 year old (31.6%) and > 5 years old (28.3%) were more likely to have cardiovascular complications. The incidence of respiratory complications was highest in 1-5 year olds (57.1%). Involvement of the digestive and the hematological systems gradually decreased with age, whereas involvement of the nervous system, the urinary system, and the joints gradually increased with age. The incidence of cardiovascular injury with extracardiac complications (22.3%) was higher than that without extracardiac complications (16.3%), although the difference was not statistically significant (p > 0.05).Conclusions: KD can be complicated by multiple-organ injury but there was no significant relationship between the occurrence of extracardiac complications and cardiovascular complications. What is Known: • Cardiovascular disease is generally believed to be the most common and serious complication of Kawasaki disease (KD). • Over recent years, we have found that extracardiovascular complications of KD are more common than generally supposed and, because they have some effect on prognosis, we believe that more attention should be paid to these complications. What is New: • There was no significant relationship between the occurrence of extracardiac complications and cardiovascular complications.
本研究旨在探讨川崎病(KD)患儿发生多种并发症的发生率及临床特点。所有患者均为 2016 年 1 月至 2020 年 12 月在我院确诊,共纳入 640 例,其中冠状动脉瘤 43 例,冠状动脉扩张 51 例,无冠状动脉损伤 546 例。根据年龄将患儿分为<1 岁、15 岁、>5 岁 3 个亚组,分析所有 KD 患儿的多种并发症及与心血管并发症的相关性。640 例 KD 患儿中,以 15 岁者居多(415/640,64.8%),<1 岁(31.6%)及>5 岁(28.3%)患儿更易发生心血管并发症;1~5 岁者以呼吸系统并发症发生率最高(57.1%),消化系统及血液系统受累随年龄增长逐渐减少,而神经系统、泌尿系统及关节受累则逐渐增加;伴发心血管损伤者的发生率(22.3%)高于无心血管损伤者(16.3%),但差异无统计学意义(P>0.05)。结论:KD 可并发多器官损伤,但无心血管损伤与伴发心血管损伤者的发生率无显著相关性。已知:• 心血管疾病通常被认为是川崎病(KD)最常见且最严重的并发症。• 近年来,我们发现 KD 的心血管外并发症比通常认为的更为常见,而且由于这些并发症对预后有一定影响,我们认为应更加关注这些并发症。新发现:• 无心血管损伤与伴发心血管损伤者的发生率无显著相关性。