澳大利亚川崎病的流行病学和临床特征。

The epidemiology and clinical features of Kawasaki disease in Australia.

机构信息

Children's Cardiac Centre, Princess Margaret Hospital for Children, Perth, Western Australia, Australia;

出版信息

Pediatrics. 2014 Apr;133(4):e1009-14. doi: 10.1542/peds.2013-2936. Epub 2014 Mar 31.

DOI:10.1542/peds.2013-2936

PMID:24685950

Abstract

OBJECTIVES

The current Australian epidemiology of Kawasaki disease (KD) is poorly defined. Previous enhanced surveillance (1993-1995) estimated an incidence of 3.7/100,000 <5 years.

METHODS

We identified all patients hospitalized in Western Australia (current population ∼2.4 million) 1979 through 2009 with a discharge diagnosis of KD. We reviewed demographic, clinical, laboratory, and echocardiographic data from individual patient files and derived age-specific population estimates. KD diagnosis was made using standard criteria.

RESULTS

There were 353 KD cases, with incomplete KD in 34 (9.6%). Male to female ratio was 1.7:1 and median age was 3.8 years (interquartile range 12-60 months). Fifty (18.1%) patients were Asian. Mean annual incidence increased from 2.82 per 100,000 children aged <5 years (95% confidence interval, 1.93-3.99) in 1980 to 1989, to 7.96 (6.48-9.67) in 1990 to 1999, to 9.34 (7.72-11.20) in 2000 to 2009. The highest incidence was 15.7 in 2005. A total of 293 children (83%) received intravenous immunoglobulin and 331 (95.4%) aspirin. Of 282 children who completed echocardiographic studies, 47 (16.7%) had coronary artery (CA) ectasia/dilatation and 19 (6.8%) had CA aneurysms; male gender was significantly associated with CA abnormalities.

CONCLUSIONS

KD epidemiology in Western Australia mirrors that of other industrialized, predominantly European-Caucasian populations. The rising incidence likely reflects both improved ascertainment and a real increase in disease burden. The current Australian incidence is threefold higher than previously reported and similar to the United Kingdom. The CA outcomes, which include the pre-intravenous immunoglobulin era, are comparable to those reported elsewhere.

摘要

目的

目前，澳大利亚川崎病（KD）的流行病学情况尚不清楚。先前的强化监测（1993-1995 年）估计发病率为每 10 万人中有 3.7 例<5 岁。

方法

我们从个体患者病历中查阅了 1979 年至 2009 年期间在澳大利亚西部住院且诊断为 KD 的所有患者的人口统计学、临床、实验室和超声心动图数据，并据此得出了特定年龄的人群估计值。KD 诊断采用了标准标准。

结果

共有 353 例 KD 病例，其中不完全 KD 为 34 例（9.6%）。男女比例为 1.7:1，中位年龄为 3.8 岁（四分位间距 12-60 个月）。50 例（18.1%）患者为亚洲人。1980 年至 1989 年，<5 岁儿童的平均年发病率为每 100,000 人 2.82 例（95%置信区间，1.93-3.99），1990 年至 1999 年为 7.96 例（6.48-9.67），2000 年至 2009 年为 9.34 例（7.72-11.20）。发病率最高的是 2005 年，为 15.7。共有 293 名儿童（83%）接受了静脉注射免疫球蛋白治疗，331 名（95.4%）接受了阿司匹林治疗。在完成超声心动图检查的 282 名儿童中，有 47 名（16.7%）存在冠状动脉（CA）扩张/扩张，19 名（6.8%）存在 CA 动脉瘤；男性与 CA 异常显著相关。