Hirose K, Nakamura Y, Yanagawa H
Department of Public Health, Jichi Medical School, Tochigi, Japan.
Acta Paediatr Jpn. 1995 Dec;37(6):667-71. doi: 10.1111/j.1442-200x.1995.tb03401.x.
To observe the secular trend of a proportion of Kawasaki disease patients with cardiac sequelae in Japan, we analyzed patients with Kawasaki disease reported to nationwide surveys of the disease during 10.5 years from July 1982 to December 1992. Of 69,382 patients reported to the surveys, 10,596 (15.3%) were reported to have cardiac sequelae such as dilatation or stenosis of coronary arteries, myocardial infarction or valvar lesions, 1 month or more after onset. The percentage of cardiac sequelae was particularly high in males, infants younger than 1 year and children older than 5 years of age. The overall prevalence declined steadily over the observed period. However, the percentage for children older than 5 years of age did not decrease, whether treated with intravenous gamma globulin or untreated. As a consequence of the increased number of patients treated with intravenous gamma globulin, the proportion of Kawasaki disease patients with cardiac sequelae decreased annually. However, the proportion of children older than 5 years of age did not decrease.
为观察日本川崎病患者出现心脏后遗症比例的长期趋势,我们分析了1982年7月至1992年12月这10.5年间全国性川崎病调查所报告的患者。在调查所报告的69382例患者中,有10596例(15.3%)在发病1个月或更长时间后被报告出现心脏后遗症,如冠状动脉扩张或狭窄、心肌梗死或瓣膜病变。心脏后遗症的比例在男性、1岁以下婴儿和5岁以上儿童中尤其高。在观察期内,总体患病率稳步下降。然而,5岁以上儿童的比例并未下降,无论是否接受静脉注射丙种球蛋白治疗。由于接受静脉注射丙种球蛋白治疗的患者数量增加,川崎病患者出现心脏后遗症的比例逐年下降。然而,5岁以上儿童的比例并未下降。