1993 - 1995年澳大利亚的川崎病
Kawasaki disease in Australia, 1993-95.
作者信息
Royle J A, Williams K, Elliott E, Sholler G, Nolan T, Allen R, Isaacs D
机构信息
Department of Immunology and Infectious Disease, Royal Alexandra Hospital for Children, Westmead, Australia.
出版信息
Arch Dis Child. 1998 Jan;78(1):33-9. doi: 10.1136/adc.78.1.33.
AIM
To describe the epidemiology, management, and rate of cardiac sequelae of Kawasaki disease in Australia.
DESIGN
Cases were notified to the Australian Paediatric Surveillance Unit, an active national surveillance scheme, from May 1993 to June 1995.
RESULTS
139 cases of Kawasaki disease were confirmed. In 1994, the annual incidence was 3.7/100,000 children < 5 years old. Sixteen children were not admitted to hospital. Coronary artery abnormalities were reported in 35 (25%) children. Two patients were diagnosed at postmortem examination. Sixty six per cent of patients were diagnosed within 10 days of onset and 81% of these received intravenous gammaglobulin within 10 days. Forty five of the notified children did not fulfil the study criteria because of streptococcal infection or insufficient clinical criteria. One child with streptococcal infection had coronary artery dilatation.
CONCLUSION
Diagnosis of Kawasaki disease was delayed beyond 10 days in one third of patients, and almost 20% of children who could have received gammaglobulin within 10 days did not. The distinction between Kawasaki disease, streptococcal infection, and other possible diagnoses is problematic in some children.
目的
描述澳大利亚川崎病的流行病学、治疗及心脏后遗症发生率。
设计
1993年5月至1995年6月期间，病例通过澳大利亚儿科监测单位上报，这是一项全国性的主动监测计划。
结果
确诊139例川崎病。1994年，5岁以下儿童的年发病率为3.7/10万。16名儿童未住院治疗。35名（25%）儿童报告有冠状动脉异常。2例患者在尸检时被诊断。66%的患者在发病10天内被诊断，其中81%在10天内接受了静脉注射丙种球蛋白治疗。45名上报的儿童因链球菌感染或临床标准不充分未符合研究标准。1名患有链球菌感染的儿童有冠状动脉扩张。
结论
三分之一的患者川崎病诊断延迟超过10天，近20%本可在10天内接受丙种球蛋白治疗的儿童未接受治疗。在一些儿童中，区分川崎病、链球菌感染及其他可能的诊断存在问题。
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