Zhou Yun, Chen Mei, Gao Wenting, Chen Yu, Meng Ying
Department of Cardiovascular Medicine, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Tex Heart Inst J. 2025 Feb 4;52(1):e248393. doi: 10.14503/THIJ-24-8393. eCollection 2025 Jan-Jun.
The impact of coronary artery aneurysms (CAAs) caused by Kawasaki disease (KD) on long-term health-related quality of life (HRQOL) in children has not been well documented.
This study investigated long-term HRQOL in a large sample of children diagnosed with KD-related CAAs. A case-control, retrospective study included 66 patients with KD-related CAAs. A total of 98 hospitalized patients were matched as controls based on age and sex: 49 patients were allocated to a group with pneumonia and 49 patients were allocated to a group with arterio-arterial fistula. Both child-reported and parent-proxy-reported Pediatric Quality of Life Inventory surveys were collected.
The median (IQR) follow-up period was 5.64 (3.81-7.47) years (range, 1.03-10.67 years). The mean (SD) age at diagnosis was 3.73 (1.93) years. At baseline, children and parents as their proxies reported similar HRQOL scores for KD-related CAAs and arterio-arterial fistula that were considerably lower than for pneumonia, respectively. At long-term follow-up, children in the small and medium-sized aneurysms group reported a mean (SD) score of 81.61 (19.50), which was comparable to the arterio-arterial fistula group (83.32 [18.24]), 9.51 points lower than that of the pneumonia group ( = .014), and 9.70 points higher than that of the giant aneurysms group ( = .012). Parents also reported a comparable mean (SD) score of 81.03 (12.57) vs 83.30 (15.17) in the small and medium-sized aneurysms group and arterio-arterial fistula group, both of which had statistically significantly lower scores than the pneumonia group ( = .010) and higher scores than the giant aneurysms group ( = .009).
Despite improvement in HRQOL scores, children with documented KD-related CAAs without complete recovery often encountered issues that disrupted their well-being during long-term follow-up. Routine outpatient HRQOL screening could be instituted to help eliminate the risk of long-term disability following initial clinical improvement.
川崎病（KD）所致冠状动脉瘤（CAA）对儿童长期健康相关生活质量（HRQOL）的影响尚未得到充分记录。
本研究调查了大量诊断为KD相关CAA的儿童的长期HRQOL。一项病例对照回顾性研究纳入了66例KD相关CAA患者。根据年龄和性别将98例住院患者匹配为对照组：49例患者被分配到肺炎组，49例患者被分配到动脉-动脉瘘组。收集了儿童自报和家长代报的儿童生活质量量表调查结果。
中位（IQR）随访期为5.64（3.81 - 7.47）年（范围1.03 - 10.67年）。诊断时的平均（SD）年龄为3.73（1.93）岁。在基线时，儿童及其家长代报的KD相关CAA和动脉-动脉瘘的HRQOL得分相似，分别显著低于肺炎组。在长期随访中，中小动脉瘤组儿童的平均（SD）得分为81.61（19.50），与动脉-动脉瘘组（83.32 [18.24]）相当，比肺炎组低9.51分（P = .014），比巨大动脉瘤组高9.70分（P = .012）。家长代报的中小动脉瘤组和动脉-动脉瘘组的平均（SD）得分分别为81.03（12.57）和83.30（15.17），两者均显著低于肺炎组（P = .010）且高于巨大动脉瘤组（P = .009）。
尽管HRQOL得分有所改善，但有记录的KD相关CAA且未完全康复的儿童在长期随访中经常遇到影响其幸福感的问题。可开展常规门诊HRQOL筛查，以帮助消除初始临床改善后长期残疾的风险。
