Research Progress of Kawasaki Disease
|Keywords||Kawasaki disease incomplete Kawasaki disease coronary artery lesion epidemiology etiology pathogenesis diagnosis treatment|
ObjectiveKawasaki disease (KD) is common in pediatric febrile disease, of unknown etiology, It is mainly involving the cardiovascular system. In recent years it has become the main cause of acquired heart disease.Understanding KD incidence and epidemiology, etiology, pathogenesis is help to guide the diagnosis and treatment of KD. Due to the lack of KD specific laboratory diagnosis index and the gold standard, KD is primarily a clinical diagnosis. The incomplete KD in an infant has a higher incidence rate, is likely complicated with coronary artery damage. Early diagnosis is difficult. As the auxiliary examination technology development, some of the early diagnosis of KD significant specificity index was found. Aspirin, immunoglobulin, adrenal cortical hormone in the treatment of KD application, is still controversial.In order to improve the clinician to the understanding of KD, early diagnosis and treatment, reduction of cardiovascular complications, improve the prognosis, this article on all aspects of KD summarizes research progress.MethodsReading in recent years at home and abroad on KD epidemiology, etiology, pathogenesis, clinical features, diagnosis, treatment and other aspects of the study, comparison of various perspectives of the similarities and differences and its theoretical basis, summarizes the clinical work is of guiding significance to the concept of.ResultsKawasaki disease incidence rate shows ascendant trend, but its specific incidence rate, the proportion of incomplete Kawasaki disease is still not clear. On the etiology of Kawasaki disease and its pathogenesis is still not clear. In 2002 Japan revised new Kawasaki disease, incomplete Kawasaki disease diagnostic criteria, including main symptoms, ultrasound heartbeat graph or cardiovascular angiography in the diagnosis of abnormal expression and its reference significance. Attention should be paid to conjunctival hyperemia, lips, skin rash, acute phase change palm foot rigidly edema and erythema, swelling of the lymph node and other characteristic changes in Kawasaki disease. Kawasaki disease clinical manifestations varied, involving multiple system. We should pay attention to the differential diagnosis. The incomplete Kawasaki disease in an infant has a higher incidence rate, complicated with coronary artery damage probability. Early diagnosis is difficult. For the fever of unknown origin in small infants, we should consider the possibility of incomplete KD. BCG inoculation site of reproducing erythema, perianal flush (or with peeling) and finger (toe) side peeling have characteristic significance for the diagnosis of incomplete KD. The United States AAP and AHA in 2004 jointly formulated the guidelines for the diagnosis and treatment of incomplete KD, guide to clinical work has important significance, standardize the diagnosis and treatment of incomplete KD. CRP, ESR, cTn levels increased, ultrasound heartbeat graph changes contribute to early diagnosis of Kawasaki disease. BNP levels and the severity of coronary artery damage in the relationship, on the significance of early diagnosis is one of the research hotspots in recent. Ultrasonic heartbeat graph is still the main diagnostic methods of coronary artery lesions. New imaging techniques such as IVUS, MSCT in CAA, CAD positioning, qualitative advantage, make up for the insufficiency of two dimensional ultrasound. Coronary artery damage risk factors include age, thrombocytosis, application of IVIG time. Large dose of aspirin, immunoglobulin is still the main method for the treatment of Kawasaki disease, but the withdrawal time, medication methods still in dispute. On coronary artery lesion treatment options are still no clear standard.