Luo Gang, Pan Si-Lin, Wang Si-Bao, DU Zhan-Hui, Ji Zhi-Xian
Heart Center, Qingdao Women and Children's Hospital, Qingdao, Shandong 266034, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Dec;22(12):1306-1312. doi: 10.7499/j.issn.1008-8830.2009138.
To study the clinical features of children with recurrent Kawasaki disease (KD).
PubMed, Web of Science, Embase, CNKI, Wanfang Med Online, and Weipu Data were searched for case-control studies on the clinical features of initial and recurrent KD. The articles were screened according to the inclusion and exclusion criteria. RevMan 5.3 software was used to perform the Meta analysis. Effect models were selected based on the results of heterogeneity test, and then pooled or weighted mean difference (), and their 95% were calculated.
A total of 9 case-control studies were included, with 12 059 children with KD in total, among whom 206 children had recurrent KD (127 boys/61.7%; 79 girls/38.3%). The results of the Meta analysis showed that compared with the initial KD onset, the children with recurrent KD had a shorter duration of fever (=-1.81, 95%:-2.99 to -0.64) and a lower proportion of children with swelling of the hands and feet (=0.46, 95%:0.26 to 0.80). There was no significant difference in the incidence rate of coronary artery lesions between recurrent KD and initial KD (=1.34, 95%:0.84 to 2.14).
Current evidence shows that children with recurrent KD tend to have a shorter duration of fever and a lower incidence of swelling of the hands and feet. KD recurrence is more common in boys. Current evidence does not show an increased risk of developing coronary artery lesions in children with recurrent KD.
研究复发性川崎病(KD)患儿的临床特征。
检索PubMed、Web of Science、Embase、中国知网、万方医学网和维普数据,查找关于初发和复发性KD临床特征的病例对照研究。根据纳入和排除标准筛选文献。使用RevMan 5.3软件进行Meta分析。根据异质性检验结果选择效应模型,然后计算合并或加权均数差()及其95%可信区间。
共纳入9项病例对照研究,KD患儿共12059例,其中206例为复发性KD(男127例/61.7%;女79例/38.3%)。Meta分析结果显示,与初发KD相比,复发性KD患儿发热持续时间较短(=-1.81,95%可信区间:-2.99至-0.64),手足肿胀患儿比例较低(=0.46,95%可信区间:0.26至0.80)。复发性KD与初发KD冠状动脉病变发生率无显著差异(=1.34,95%可信区间:0.84至2.14)。
现有证据表明,复发性KD患儿发热持续时间往往较短,手足肿胀发生率较低。KD复发在男孩中更为常见。现有证据未显示复发性KD患儿发生冠状动脉病变的风险增加。