Baker Annette L, Gauvreau Kimberlee, Newburger Jane W, Sundel Robert P, Fulton David R, Jenkins Kathy J
Department of Cardiology, Children's Hospital, Boston, Massachusetts 02115, USA.
Pediatrics. 2003 Mar;111(3):579-83. doi: 10.1542/peds.111.3.579.
The purpose of this study was to examine the physical and psychosocial well-being of children who have had Kawasaki disease (KD), including the influence of coronary artery status on health and health perceptions.
The Child Health Questionnaire (CHQ) measures overall physical and psychosocial well-being in children 5 to 18 years. To study the long-term impact of KD on overall health status, we mailed the CHQ to patients without a history of coronary artery abnormalities (normal group), with regressed aneurysms (regressed group), with current coronary aneurysms <8 mm (mild-moderate aneurysm group), and with giant aneurysms >or=8 mm (giant group).
Of 201 questionnaires mailed, 174 were delivered and 110 (63%) were completed. Median age (range) at completion was 10.5 years (5.1-17.9 years) and at illness onset was 3.1 years (0.2-12 years). There were no significant differences in psychosocial summary scores in any of the Kawasaki groups when compared with the US population sample. Physical summary scores were also similar to the US population sample in the normal coronary, mild-moderate aneurysm, and regressed aneurysm groups. However, the giant aneurysm group had significantly lower physical summary scores compared with the US population sample. Among subscales, general health perceptions in the KD groups were lower than in the US population sample, reaching statistical significance in all but the mild to moderate aneurysm group. In addition, parents whose children have had KD reported a higher proportion of anxiety issues, allergies, and orthopedic/bone/joint issues in their children than did the general US population sample. We did not find any difference in the incidence of attentional, behavioral, or learning issues when compared with the US population sample.
KD patients without coronary artery aneurysms were similar to the general population in their general physical and psychosocial health. However, the parents of children in all KD groups reported lower general health perceptions than parents in the US population sample, suggesting that long-term concerns about their children's health exist regardless of overall health status. In addition, children with giant coronary artery aneurysms had lower overall physical summary scores.
本研究旨在调查患有川崎病（KD）的儿童的身体和心理社会健康状况，包括冠状动脉状况对健康及健康认知的影响。
儿童健康问卷（CHQ）用于评估5至18岁儿童的整体身体和心理社会健康状况。为研究KD对整体健康状况的长期影响，我们将CHQ邮寄给无冠状动脉异常病史的患者（正常组）、动脉瘤已消退的患者（消退组）、当前冠状动脉瘤直径<8 mm的患者（轻度至中度动脉瘤组）以及动脉瘤直径≥8 mm的巨大动脉瘤患者（巨大组）。
在邮寄的201份问卷中，174份送达，110份（63%）完成。完成问卷时的中位年龄（范围）为10.5岁（5.1 - 17.9岁），发病时的中位年龄为3.1岁（0.2 - 12岁）。与美国人群样本相比，任何川崎病组的心理社会总结得分均无显著差异。正常冠状动脉组、轻度至中度动脉瘤组和消退动脉瘤组的身体总结得分也与美国人群样本相似。然而，巨大动脉瘤组的身体总结得分显著低于美国人群样本。在各分量表中，KD组的总体健康认知低于美国人群样本，除轻度至中度动脉瘤组外，其余组均达到统计学显著水平。此外，孩子患有KD的家长报告其孩子出现焦虑问题、过敏以及骨科/骨骼/关节问题的比例高于美国普通人群样本。与美国人群样本相比，我们未发现注意力、行为或学习问题的发生率有任何差异。
无冠状动脉瘤的KD患者在总体身体和心理社会健康方面与普通人群相似。然而，所有KD组儿童的家长报告的总体健康认知低于美国人群样本中的家长，这表明无论整体健康状况如何，他们对孩子健康的长期担忧依然存在。此外，患有巨大冠状动脉瘤的儿童总体身体总结得分较低。
