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川崎病不同年龄段的心血管及血小板动态变化
Received 14 January 2025
Accepted for publication 10 September 2025
Published 16 October 2025 Volume 2025:18 Pages 6265—6278
DOI https://doi.org/10.2147/IJGM.S515118
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Yuriy Sirenko
Fen Wang,1,* Zhongxing Lu,2,* Haitao Lv3
1Department of Pediatrics, The First People’s Hospital of Taicang City, Taicang, Jiangsu, 215400, People’s Republic of China; 2Department of Pediatrics, Changzhou Maternal and Child Health Care Hospital, Changzhou, Jiangsu, 213000, People’s Republic of China; 3Department of Cardiovascular, Children’s Hospital of Soochow University, Suzhou, Jiangsu, 215003, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhongxing Lu, Department of Pediatrics, Changzhou Maternal and Child Health Care Hospital, No. 16 Dingxiang Road, Zhonglou District, Changzhou, Jiangsu, 213000, People’s Republic of China, Tel +86 13382838205, Email szdxlzx@126.com
Objective: To characterise age-specific differences in clinical manifestations, treatment response and platelet dynamics in Kawasaki disease (KD).
Methods: A retrospective analysis was conducted on 221 patients with KD who were admitted to the cardiology department of Suzhou Children’s Hospital between June 2015 and May 2016. Patients were divided into three groups based on age: the infant group (≤ 12 months), the toddler group (> 12 months to ≤ 36 months) and the child group (> 36 months to ≤ 10 years). Clinical symptoms, signs, echocardiography (ECHO) findings, treatment characteristics and platelet counts were compared among the groups. Multivariate logistic regression was performed to identify independent predictors of severe cardiovascular damage. A P-value of < 0.05 was considered significant.
Results: Major symptoms, such as lymph node enlargement and finger (toe) peeling, were significantly more pronounced in the toddler and child groups (P < 0.05). The overall incidence of cardiovascular damage was 56.1%, with 31.7% experiencing intravenous immunoglobulin (IVIG) resistance. Treatment delay (≥ 10 days from fever onset) occurred in 18.6% of cases and was associated with increased cardiovascular severity (adjusted odds ratio [aOR] = 2.45, 95% confidence interval [CI] 1.32– 4.56, P = 0.004). Platelet counts and plateletcrit increased significantly during the acute and subacute phases, with the infant group exhibiting significantly higher platelet responses than the toddler and child groups (all P < 0.05). Multivariate analysis revealed that elevated platelet distribution width was independently associated with moderate-to-severe coronary artery lesions (aOR = 1.38, 95% CI 1.09– 1.74, P = 0.007).
Conclusion: The clinical characteristics, ECHO findings, treatment patterns and platelet changes in patients with KD exhibit partial age‐related differences. Treatment delay and IVIG resistance significantly impact cardiovascular outcomes. Clinicians are advised to incorporate age-specific diagnostic and treatment strategies, paying particular attention to timely intervention and platelet monitoring to facilitate early recognition and optimise clinical outcomes.
Keywords: Kawasaki disease, symptom, sign, platelet change, cardiovascular damage, echocardiography, IVIG resistance, treatment delay