Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Department of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC.
J Chin Med Assoc. 2020 Mar;83(3):302-306. doi: 10.1097/JCMA.0000000000000266.
The relationship between adenovirus infection and Kawasaki disease (KD) is unclear. The purpose of this study was to determine the relationship between adenovirus infection and KD using a cohort study in Taiwan.
We used Taiwan National Health Insurance data (from 2000 to 2008) to conduct a population-based cohort study, analyzing children that was under 18 years of age. In total, 5280 children had adenovirus infection, and 5280 children without adenovirus infection were matched and followed up. Subsequent KD was the major outcome event. The Cox proportional hazards model was used to estimate the hazard ratio (HR) with 95% confidence intervals (CIs) of developing KD associated with adenovirus infection.
There was a significantly higher cumulative incidence of KD in the adenovirus-infected cohort than that in the control cohort (log-rank test, p < 0.001). In the adenovirus-infected cohort, overall incidence of KD was 5.29 times higher than that of the control cohort (adjusted HR 5.29, 95% CI: 2.48-11.3). Increased KD risk was associated with previous adenovirus infection in children aged 3-5 years, in female patients, in those with a low urbanization level, and in those with allergies.
An association between previous adenovirus infection and KD was identified in Taiwanese children, but other potential risk factors were not fully analyzed. The relationship between infection and KD requires further study.
腺病毒感染与川崎病（KD）之间的关系尚不清楚。本研究旨在通过台湾的队列研究来确定腺病毒感染与 KD 之间的关系。
我们使用台湾全民健康保险数据（2000 年至 2008 年）进行了一项基于人群的队列研究，分析了年龄在 18 岁以下的儿童。共有 5280 例儿童患有腺病毒感染，且匹配了 5280 例无腺病毒感染的儿童进行随访。随后的 KD 是主要的结局事件。采用 Cox 比例风险模型估计了与腺病毒感染相关的 KD 发病的风险比（HR）及其 95%置信区间（CI）。
腺病毒感染组的 KD 累积发生率明显高于对照组（对数秩检验，p<0.001）。在腺病毒感染组中，KD 的总发生率是对照组的 5.29 倍（调整 HR 5.29，95%CI：2.48-11.3）。在年龄为 3-5 岁、女性、城市化水平较低和过敏的儿童中，KD 发病风险增加与既往腺病毒感染有关。
在台湾儿童中发现了既往腺病毒感染与 KD 之间的关联，但其他潜在的危险因素未被充分分析。感染与 KD 之间的关系需要进一步研究。
