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Objective: To explore the risk factors for coronary artery lesions(CAL) caused by Kawasaki disease(KD) and compare the factors associated with coronary artery(CA) dilation only versus CA aneurysms(CAA).Methods: We retrospectively reviewed clinical records of 1345 patients with Kawasaki disease admitted in our department during Jan, 2003 to Dec, 2009: (1) Clinical features of different age groups with KD were analyzed; (2) Univariate analysis and multivariate logistic regression analysis for 18 influence factors associated with CAL were performed to explore the risk factors for CAL; (3) Determine the differences exist in the factors associated with CAA compared to CA dilation only.Results: (1) Significant differences(P<0.05) were demonstrated in different age groups with KD about the incidence of clinical features except for bulbar conjunctival injection and perianal desquamation. The incidence of rash and redness at Bacille Calmette-Guèrin(BCG) inoculation site is the highest in infants aged<6 months, while the occurrence rate of membranous desquamation from fingertips is the lowest in children who are older than 6 months and younger than 60 months. Cervical lymphadenopathy, membranous desquamation from fingertips and strawberry tongue are easier to seen in patients who are older than 60 months; (2) Of 1345 patients with KD, 484(36.0%) had occurred CAL, of which 370(27.5%) had CA dilation only, 101(7.5%) had medium CAA, and 13(0.97%) had giant CAA. Univariate analysis showed that age, gender, total duration of fever, therapeutic time windows and doses of intravenous immunoglobulin(IVIG), white blood cell count(WBC), percentage of neutrophils(N%), hemoglobin(Hb), hematocrit(Hct), platelet(PLT) count, erythrocyte sedimentation rate(ESR), serum aspartate aminotransferase(AST) were significantly related to CAL(P<0.05). Multivariate logistic regression analysis identified that age, gender, therapeutic time windows and doses of IVIG, PLT, ESR as risk factors of CAL(P<0.05); (3) Univariate analysis showed that age, total duration of fever, therapeutic time windows of IVIG, Hb, Hct, PLT, serum albumin(ALB) were significantly related to CAA in patients with CAL(P<0.05). Multivariate logistic regression analysis identified that CA dilation only and CAA differ only in the total duration of fever(P<0.05).Conclusions: (1) Redness at BCG inoculation site is easier to seen in young infants, while cervical lymphadenopathy is often found in school age children; (2) Male, young children, delayed administration of IVIG(>10 d), doses of IVIG, high lever of PLT, elevated ESR are the high risk factors for CAL caused by KD; (3) The total duration of fever(>10 d) is the risk factor for CAA in patients with CAL.
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