Yanagawa Hiroshi, Nakamura Yosikazu, Yashiro Mayumi, Uehara Ritei, Oki Izumi, Kayaba Kazunori
Saitama Prefectural Universit, Koshigaya, Japan.
Pediatr Int. 2006 Aug;48(4):356-61. doi: 10.1111/j.1442-200X.2006.02221.x.
The purpose of the present study was to describe the results of nationwide epidemiologic surveys of Kawasaki disease for the 4 year period 1999-2002.
The design is a retrospective incidence survey. The patients reported in these two surveys are all new patients who were reported during the two study periods (1999-2000 and 2001-2002), although the data were collected retrospectively. A questionnaire was sent to all pediatric departments of hospitals with 100 beds or more throughout Japan, requesting data on patients with Kawasaki disease, such as sex, age, date of first hospital visit, recurrence, and cardiac lesions.
The total number of patients reported in the 4 year period 1999-2002 was 32 266 (18 604 male, 13 662 female), with an average annual incidence of 137.7 per 100 000 children younger than 5 years old. The male/female ratio was 1.30. The incidence peaked at 9-11 months of age, and the proportion of patients under 1 year of age was 26%. The monthly distribution had a high peak in January and a gradual increase in summer. Geographically, the high-incidence areas were limited to certain prefectures and moved from year to year. The cardiac lesions at acute stage and cardiac sequelae occurred more in children under 1 year and older than 4 years. Among the principal symptoms, fever persisting >or=5 days occurred most commonly, followed by conjunctival congestion, changes in lips and oral cavity, polymorphous exanthema, and changes of extremities. Cervical lymphadenopathy occurred less.
More than 32 000 patients with Kawasaki disease during the 4 year period 1999-2002 were reported to the nationwide incidence surveys. The number of patients is steadily increasing despite the decrease of children. The seasonal variation, geographical distribution, and age-specific distribution support the infection theory for the etiology of Kawasaki disease.
本研究的目的是描述1999 - 2002年这4年期间全国范围内川崎病的流行病学调查结果。
采用回顾性发病率调查设计。这两项调查中报告的患者均为在两个研究时间段（1999 - 2000年和2001 - 2002年）期间报告的新患者，尽管数据是回顾性收集的。向日本全国所有拥有100张及以上床位的医院儿科发送了一份问卷，要求提供川崎病患者的数据，如性别、年龄、首次就诊日期、复发情况和心脏病变。
1999 - 2002年这4年期间报告的患者总数为32266例（男性18604例，女性13662例），5岁以下儿童的年平均发病率为每10万人137.7例。男女比例为1.30。发病率在9 - 11个月龄时达到峰值，1岁以下患者的比例为26%。月度分布在1月有一个高峰，夏季逐渐上升。在地理上，高发病区仅限于某些县，且逐年变动。急性期心脏病变和心脏后遗症在1岁以下和4岁以上儿童中更为常见。在主要症状中，持续发热≥5天最为常见，其次是结膜充血、嘴唇和口腔变化、多形性红斑以及四肢变化。颈部淋巴结病较少见。
在1999 - 2002年这4年期间，全国发病率调查共报告了32000多名川崎病患者。尽管儿童数量减少，但患者数量仍在稳步增加。季节变化、地理分布和年龄特异性分布支持川崎病病因的感染理论。
