Chen Jing-Jing, Ma Xiao-Jing, Liu Fang, Yan Wei-Li, Huang Mei-Rong, Huang Min, Huang Guo-Ying
From the *Pediatric Heart Center, Children's Hospital of Fudan University; †Pediatric Heart Center, Shanghai Children's Medical Center; and ‡The Speciality of Cardiovascular Disease, Children's Hospital of Shanghai Jiaotong University, Shanghai, China.
Pediatr Infect Dis J. 2016 Jan;35(1):7-12. doi: 10.1097/INF.0000000000000914.
This study was to investigate the epidemiologic trends of Kawasaki disease (KD) and coronary arterial lesions (CALs) in Shanghai from 2008 through 2012.
Data were collected by using the network of the KD research group established during the first survey in Shanghai to conduct the third survey, covering the period from 2008 through 2012. Clinical records of 2304 patients with acute KD were retrospectively reviewed. Epidemiologic features of KD were investigated. Univariate and multivariate analyses were performed to identify the risk factors for CAL in patients with KD. The data were compared with the previous 2 surveys covering the periods from 1998 to 2002 and 2003 to 2007, respectively.
The average incidence of KD was 30.3 to 71.9 per 100,000 children aged 0-4 years from 2008 through 2012. Age at onset ranged from 32 days to 11.7 years (median: 2.3 years). The occurrence of KD was more common in summer and spring. A total of 365 (15.9%) cases developed CAL defined as ectasia or aneurysm. Male, age ≤ 1 year, intravenous immunoglobulin (IVIG) unresponsiveness, a smaller administrative dosage and the delayed administration of IVIG (>10 days) were independent risk factors for CAL. The occurrence of CAL seemed less frequent in patients who received IVIG within 5 days after onset of illness.
The incidence of KD in children has increased over time, and the development of CAL decreased in the past 5 years in Shanghai. Earlier treatment with IVIG (<5 days) was associated with reduced CAL among patients with KD.
本研究旨在调查2008年至2012年上海川崎病（KD）及冠状动脉病变（CALs）的流行病学趋势。
利用上海首次调查时建立的KD研究组网络收集数据，进行第三次调查，涵盖2008年至2012年期间。回顾性分析2304例急性KD患者的临床记录。调查KD的流行病学特征。进行单因素和多因素分析以确定KD患者发生CAL的危险因素。将数据分别与之前涵盖1998年至2002年和2003年至2007年的两次调查结果进行比较。
2008年至2012年，0至4岁儿童KD的平均发病率为每10万人30.3至71.9例。发病年龄范围为32天至11.7岁（中位数：2.3岁）。KD在春夏季节更为常见。共有365例（15.9%）发生CAL，定义为扩张或动脉瘤。男性、年龄≤1岁、静脉注射免疫球蛋白（IVIG）无反应、较小的给药剂量以及IVIG延迟给药（>10天）是CAL的独立危险因素。发病后5天内接受IVIG治疗的患者中CAL的发生率似乎较低。
上海儿童KD的发病率随时间增加，过去5年CAL的发生率有所下降。KD患者早期使用IVIG（<5天）治疗与CAL发生率降低有关。
