2002-2007年川崎病289例回顾性分析

Retrospective Study of 289 Cases with Kawasaki Disease from 2002 to 2007

目的总结本院近5a川崎病(KD)的流行病学特征,探讨KD并心血管疾病的危险因素。方法回顾性分析2002年1月-2007年12月289例住院KD患儿的临床资料,分析KD近5a的流行病学特点,包括年龄、性别、发病季节及临床特征、并发症、药物应用及各项实验室指标;采用SPSS13.0软件评估KD并心血管病变的高危因素,计数资料采用χ2检验及Fisher′s精确概率法,计量资料数据以-x±s表示,采用t检验;P<0.05为差异有统计学意义。结果289例KD患儿中,男184例,女105例;<5岁237例(82.0%);发病年龄(34.06±30.11)个月;5-9月份为发病高峰,共167例,占57.8%。KD并心脏损害者52例,发生率为18%,其中冠状动脉病变39例。238例KD患儿在病程2～25d接受静脉丙种球蛋白治疗,其中198例(83.2%)在病程10d内接受丙种球蛋白治疗,发现KD患者确诊后采用不同静脉丙种球蛋白治疗剂量与心脏病变发生率无明显相关性(P>0.05)。单因素分析显示红细胞沉降率与KD并心血管损害有相关性(P<0.001)。结论红细胞沉降率增快是KD并心血管病变的高危因素,但KD并心脏病变的临床高危因素迄今尚不明确,开展多中心大样本的循证医学研究非常必要。

Objective To investigate the epidemiologic characteristics and to find out risk factors of Kawasaki disease（KD） with cardio- vascular disease. Methods Clinical features, dagnosis and treatment for totally 289 children with KD hospitalized from Jan. 2002 to Dec. 2007 were reviewed. Epidemiologic features （sex, age and time of disease） , characters, complications and laboratory examinations of KD were com- pared. Also,the high risk factors for KD with complication of cardiovascular disease was investigated. The data were analized by SPSS 13.0 software with X2 and Fisher＇s exact probability. Measurement data were showed by x ± s and were calculated by t test. It meaned statistic differ- ence if P 〈 0.05. Results One hundred and eighty - four cases were male and 105 cases were female in 289 cases of KD. The median age were （34.06 ± 30.11 ） months old. The disease occurred more frequently from May. through Sep. （57.8%）. The incidence of KD with cardio- vascular disease was 18% and there were 39 KD children with coronary artery lesion. Two hundred and thirty - eight KD children were treated with intravenous immunoglobulin in illness day （2 -25 d） and no difference was found between several intravenous immunoglobulin therapies and cardiac disease occurrence（ P 〉 0.05 ）. Erythrocyte sedimentation rate （ESR） was related with KD with cardiovascular disease （ P 〈 0. 001 ）. Conclusions ESR is the high risk factor in KD with cardiovascular disease. And what is the clinical high risk factor in KD with cardio- Vascular is not much clear. However the multi - center study is need to get the more precise result.