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1995~1999年北京住院小儿川崎病流行病学调查

Epidemiologic study of admitted children with Kawasaki Disease in Beijing from 1995 to 1999

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【作者】 杜忠东梁璐孟晓萍李棠张拓红川崎富作柳川洋北京小儿川崎病流行病学调查协作组

【Author】 DU Zhong-dong*, LIANG Lu, MENG Xiao-ping, LI Tang, ZHANG Tuo-hong, Kawasaki T, Yanagawa H.*Beijing Children Kawasaki Disease Co-operation group. Beijing Children′s Hospital, Capital Institute of Pediatrics, Peking Universiy, Beijing 100045, China

【机构】 首都医科大学附属北京儿童医院心脏中心首都儿科研究所心内科北京大学公共卫生学院社会医学系日本川崎病研究中心日本Saitama Prefectural大学 100045北京100045北京

【摘要】 目的 了解北京小儿川崎病的发病率及流行病学特点 ,并与其他地区比较。方法 按照日本全国小儿川崎病调查方法 ,向北京及其郊区所有拥有儿科住院病床的医院发出调查问卷和川崎病的诊断标准 ,回顾性记录自 1995年 1月至 1999年 12月期间诊断为川崎病的所有患儿。参加调查人员均为小儿心血管医生或是高年资儿科医生 ,由 2名高年资儿科医生监督确保调查严格按照研究方案进行。心血管并发症是指川崎病起病 1个月内发生的经超声心动图或冠脉造影证实的心脏扩大 ,冠状动脉扩张、狭窄或阻塞 ,心肌梗塞 ,或心脏瓣膜损害。结果 北京 39家有儿科住院病床的医院中 ,37家 (95 % )参加调查 ,共计报告 710例患儿 ,1995~ 1999年北京 5岁以下小儿川崎病年发病率分别为 18 2 / 10万、2 1 1/ 10万、18 6 / 10万、30 6 / 10万和 2 7 8/ 10万。男女发病比例为 1 7∶1,发病年龄从 1月至 13 4岁 (平均 2 3岁 ) ,其中 5岁以下占 85 2 %。本病在春、夏两季发病较多 ,秋冬较少。淋巴结肿大是最少见的临床症状 ,且其发生率自 1995至 1999年逐年降低。 2 1 5 %的患儿发生心血管并发症 ,见于起病后 10或 10d以上才确诊的患儿 ,患儿急性期无死亡。结论 北京地区川崎病的发病率低于日本 ,而与美国的发病率相当 ,但高于其他西方?

【Abstract】 Objective To evaluate the epidemiologic picture of Kawasaki disease (KD) in Beijing and its suburbs. Methods A questionnaire form and diagnostic guideline for KD were sent to all hospitals with pediatric inpatient beds throughout Beijing and its suburbs. Pediatricians were asked to review the medical records and report all patients with KD diagnosed during the 5-year period from January, 1995, to December, 1999. Results A total of 710 patients with KD were reported from 37 (95%) of 39 hospitals with pediatric inpatient beds. The incidence rates of KD were 18.2 (1995), 21.1 (1996), 18.6 (1997), 30.6 (1998) and 27.8 (1999) per 100 000 children <5 years of age. The male:female ratio was 1.7∶1. The age at onset ranged from 1 month to 13.4 years (with median of 2.3 years), with 85.2% <5 years old. The disease occurred more frequently in spring and summer and less frequently in autumn and early winter. Lymph node enlargement was the least common clinical sign, and its incidence decreased from 1995 to 1999. Cardiac abnormalities were found in 21.5% of patients and were more prevalent in patients diagnosed 10 days or longer after the onset. No patients died in the acute stage. Conclusions The incidence of KD in Beijing is lower than that reported in Japan, similar to the incidence in the United States and higher than in those other Western countries. The age and gender distribution and increasing trend in incidence are similar to those in previous reports, but seasonal distribution is unique.

  • 【文献出处】 中华医学杂志 ,National Medical Journal of China , 编辑部邮箱 ,2003年21期
  • 【分类号】R725.4
  • 【被引频次】34
  • 【下载频次】283
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