Sonobe Tomoyoshi, Kiyosawa Nobuyuki, Tsuchiya Keiji, Aso Seijiro, Imada Yoshio, Imai Yoko, Yashiro Mayumi, Nakamura Yoshikazu, Yanagawa Hiroshi
Department of Pediatrics, Japanese Red Cross Medical Center, Tokyo, Japan.
Pediatr Int. 2007 Aug;49(4):421-6. doi: 10.1111/j.1442-200X.2007.02396.x.
The aim of the present study was to determine the prevalence of coronary artery abnormality (CAA) and other clinical features in patients with incomplete Kawasaki disease (iKD) using the data from the 17th Japanese nationwide survey of KD.
iKD was defined as the presence of four or fewer of the principal symptoms of the Japanese diagnostic guidelines, regardless of whether the patient had CAA. A total of 15,857 cases were analyzed.
Among 15,857 cases, 83.9% of patients had five to six principal symptoms (complete KD: cKD), and 16.1% had iKD. The prevalence of CAA in cKD was 14.2%, and 18.4% in iKD. The prevalence of CAA in patients with four principal symptoms was 18.1%, which was higher than in cKD cases (14.2%). Although the reliability of the data has some limitations, the prevalence of CAA among patients with one to three symptoms was 19.3%. Among all CAA patients, 14% had four symptoms, and 6% had only one to three symptoms.
Incomplete KD should not be equated with mild KD. Patients with four principal symptoms were comparable to cKD with respect to CAA occurrence. In patients with one to three symptoms also, especially in those under 1 year and older than 4 years of age, other significant symptoms and laboratory findings of the guidelines are very important in making a correct and early diagnosis of iKD so as to prevent CAA.
本研究旨在利用日本第17次全国川崎病调查的数据，确定不完全川崎病（iKD）患者冠状动脉异常（CAA）的患病率及其他临床特征。
iKD定义为符合日本诊断指南主要症状的数量为四个或更少，无论患者是否患有CAA。共分析了15857例病例。
在15857例病例中，83.9%的患者有五至六个主要症状（完全性川崎病：cKD），16.1%的患者患有iKD。cKD中CAA的患病率为14.2%，iKD中为18.4%。有四个主要症状的患者中CAA的患病率为18.1%，高于cKD病例（14.2%）。尽管数据的可靠性存在一些局限性，但有一至三个症状的患者中CAA的患病率为19.3%。在所有CAA患者中，14%有四个症状，6%只有一至三个症状。
不完全川崎病不应等同于轻度川崎病。有四个主要症状的患者在CAA发生方面与cKD相当。在有一至三个症状的患者中，尤其是1岁以下和4岁以上的患者，指南中的其他重要症状和实验室检查结果对于iKD的正确早期诊断以预防CAA非常重要。
