Lin Yahui T, Manlhiot Cedric, Ching Joyce C Y, Han Ra K, Nield Lynne E, Dillenburg Rejane, Pepelassis Dion, Lai Lillian S, Smythe John F, Chahal Nita, Yeung Rae S M, McCrindle Brian W
Labatt Family Heart Centre, Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Int. 2010 Oct;52(5):699-706. doi: 10.1111/j.1442-200X.2010.03092.x.
Rising incidences of Kawasaki disease (KD) have been reported worldwide. Reported herein are the results of 4 triennial KD surveillances conducted in Ontario.
Between 1995 and 2006 all hospitals in Ontario were asked on 4 occasions to identify all patients with discharge diagnoses of KD and report incident cases.
The latest surveillance identified 697 new KD patients (100% response rate) for a total of 2378 KD patients through all 4 surveillances. Yearly incidence was 26.2/100,000 for <5 years old, 6.7/100,000 for 5-9 years old and 0.9/100,000 for 10-14 years old. KD incidence significantly increased from 1995 to 2006, although the increase seemed to plateau between the 3rd and 4th surveillance. There was an increase in the proportion of patients diagnosed with incomplete KD and a significant reduction in the rate of coronary artery abnormalities, possibly due to better disease recognition and treatment. Hospitals reporting <20 cases per surveillance were found to be more likely to report cases with incomplete KD. These patients were also less likely to be treated with i.v. immunoglobulin and aspirin but were more likely to be treated with antibiotics, suggesting uncertainties regarding diagnosis and management of KD patients in those centers.
The incidence of KD in Ontario is possibly one of the highest outside of Asia and has been rising since 1995. Although the most recent surveillance demonstrated improved cardiac outcomes, treatment delays or absence thereof continue to be a problem. Effective diagnosis and prompt treatment remain critical aspects of KD management.
全球范围内川崎病（KD）的发病率呈上升趋势。本文报告了在安大略省进行的4次为期三年的KD监测结果。
1995年至2006年期间，安大略省的所有医院被要求4次识别所有出院诊断为KD的患者并报告新发病例。
最新一次监测共识别出697例新的KD患者（应答率为100%），通过全部4次监测，KD患者总数达到2378例。<5岁儿童的年发病率为26.2/10万，5-9岁儿童为6.7/10万，10-14岁儿童为0.9/10万。1995年至2006年期间，KD发病率显著上升，不过在第3次和第4次监测之间似乎趋于平稳。不完全KD诊断患者的比例有所增加，冠状动脉异常发生率显著降低，这可能归因于疾病识别和治疗水平的提高。发现每次监测报告病例数<20例的医院更有可能报告不完全KD病例。这些患者接受静脉注射免疫球蛋白和阿司匹林治疗的可能性也较小，但接受抗生素治疗的可能性较大，这表明这些中心在KD患者的诊断和管理方面存在不确定性。
安大略省的KD发病率可能是亚洲以外地区最高的之一，自1995年以来一直在上升。尽管最近一次监测显示心脏预后有所改善，但治疗延迟或缺乏治疗仍然是一个问题。有效的诊断和及时的治疗仍然是KD管理的关键环节。
