Children's Hospital of Fudan University, Shanghai 201102, China.
Chin Med J (Engl). 2010 Oct;123(19):2629-34.
The epidemiologic pictures of Kawasaki disease (KD) in Shanghai from 1998 through 2002 were reported, while the current status of KD in the following five years remains unknown.
A questionnaire form and diagnostic guidelines for KD were sent to 50 hospitals providing pediatric medical care in Shanghai, China. All patients with KD diagnosed during January 2003 through December 2007 were recruited.
In total, 1187 cases of KD were enrolled. The incidence of KD was 36.78 to 53.28 (mean 46.32 ± 6.51) per 100 000 children under the age of 5 years between 2003 and 2007, which was higher than the year from 1998 to 2002 of (27.32 ± 7.11) per 100 000, (t = 4.406, P = 0.002). Ages at onset ranged from 12 days to 13.6 years (median 1.8 years). It occurred more frequently in summer and spring. Coronary arterial lesions (CAL), defined as ectasia or aneurysm, accounted for 19.8% (232 cases). Flattened or inverted T wave was the most frequent finding (194 cases, 20.5%) by electrocardiogram. Intravenous gamma-globulin was administrated to 1028 cases (86.6%). The occurrence of CAL seemed less frequent in the patients received gamma-globulin from day 5 to day 9 after the onset with the regimen of 1000 mg/kg once or 1000 mg/kg twice.
The incidence of KD was increasing in Shanghai. Treatment with intravenous gamma-globulin from day 5 to day 9 after the onset with the regimen of 1000 mg/kg once or 1000 mg/kg twice resulted in less coronary sequelae.
1998 年至 2002 年上海川崎病(KD)的流行病学情况已有报道,而此后五年的 KD 现状尚不清楚。
向中国上海提供儿科医疗服务的 50 家医院发放了问卷表和 KD 诊断指南。招募 2003 年 1 月至 2007 年 12 月期间诊断的所有 KD 患儿。
共纳入 1187 例 KD 患儿。2003 年至 2007 年,5 岁以下儿童 KD 的发病率为 36.78 至 53.28(平均 46.32±6.51)/10 万,高于 1998 年至 2002 年的 27.32±7.11/10 万(t=4.406,P=0.002)。发病年龄为 12 天至 13.6 岁(中位数 1.8 岁)。夏季和春季发病较多。冠状动脉病变(CAL)定义为扩张或动脉瘤,占 19.8%(232 例)。心电图最常见的发现是平坦或倒置的 T 波(194 例,20.5%)。1028 例(86.6%)患儿给予静脉注射丙种球蛋白。发病后第 5 至 9 天给予 1000mg/kg 单次或 1000mg/kg 2 次的方案,CAL 的发生率似乎较低。
上海 KD 的发病率呈上升趋势。发病后第 5 至 9 天给予 1000mg/kg 单次或 1000mg/kg 2 次的方案治疗静脉注射丙种球蛋白可减少冠状动脉后遗症。