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Clinical grading and risk factors of coronary arterial lesions in patients with Kawasaki disease.

??Abstract?? Objective To analyze the characteristics and risk factors of coronary artery lesions ??CAL?? in Kawasaki disease ??KD?? based on the clinical grading. Methods The clinical records of 1253 KD patients admitted to Children’s Hospital of Fudan university from January 2000 to June 2011 were analyzed retrospectively. Results ??1??Coronary arterial lesions occurred in 304 cases with the incidence of 24.3% in KD patients. According to the clinical grading of CAL of KD?? among 304 CAL patients?? 32 cases ??10.5%?? were grade II??251 cases ??82.6%?? were grade ?? 13 cases ??4.3%?? were grade ????and 8 cases??2.6%?? were grade V?? with the prevalence in KD patients of 2.6%??20.0%??1.0%??and 0.64% respectively. ??2??In all CAL patients?? single?? double?? three and four coronary branch lesions accounted for 42.4%?? 29.3%??16.1% and 12.2% respectively. The lesions of left main trunk??left anterior descending branch??left circumflex branch and right coronary artery accounted for 43.5 %??18.6%??6.8 % and 31.1% of all the branches involved respectively. ??3??The results of single factor analysis and multivariate logistic regression analysis showed that incomplete KD and elevated C reactive protein ????100 mg/L?? were the risk factors of grade ?? CAL?? while male sex?? age younger than 1 year?? duration of fever over 10 days?? incomplete KD and low serum albumin ????30 g/L?? were the risk factors of Grade ????CAL. Conclusions ??1??Grade III CAL is the most common type in KD patients, accounting for 82.6% of CAL. ??2??About 57.6% CAL occurs in two and abovetwo branches of coronary arteries. ??3??The most frequently involved branch is left main trunk, followed by right coronary artery??left anterior descending branch and circumflex branch. ??4??Being male?? age??1 year old?? incomplete KD?? long-lasting fever ????10 d?? and low serum albumin ????30 g/L?? are the independent risk factors of grade ????CAL.