吉林省1999-2008年小儿川崎病流行病学调查

Study on Epidemiology of Kawasaki Disease in Jilin Province from 1999 to 2008

目的了解吉林省近10 a来川崎病(KD)的发病、分布、流行特征及临床特点。方法由吉林省KD流行病调查协作组制定统一的KD流行病调查表,发至全省有儿科病床的县市级以上医院,对1999年1月1日-2008年12月31日住院的KD患儿进行填表调查。应用SPSS15.0软件进行统计学分析。结果调查表回收率93.75%,10 a间8个地区32家医院共报告确诊KD患儿577例。1999年为18例,而2008年达122例,确诊KD的病例数呈逐年增高趋势。男382例(66.2%),女195例(33.8%),男女之比为1.96 1;发病年龄为(2.67±2.37)岁(58 d～14岁),最大为14岁,5岁以下512例(88.73%)。发生冠状动脉病变后遗症者14例,占患者总数的2.4%,男女之比为3.67 1。发病年龄越小,心脏后遗症的发病率越高。后遗症以冠状动脉扩张为主。就诊距起病时间为(7.58±4.63)d。其中有4个少数民族共50例患儿,占8.7%。全年均可发病,其中5-7月份和11月份为发病高峰季节。急性期冠状动脉改变占63.26%;复发率占0.5%,急性期无死亡病例。结论吉林省KD发病率呈增高趋势。发病年龄和性别比例与以往报道略有差异。发病季节有夏季、冬季2个高峰,与美国、日本和国内一些地区报道的春夏两季高发及无明显的发病高峰不一致。

Objective To investigate the epidemiological characteristics and clinical prognosis of Kawasaki disease （KD） in Jilin province for recent 10 years. Methods The survey forms unified of standard KD epidemiology were used and sent to the province＇s 32 hospitals above the county and city level with pediatric in -patients,in order to conduct a survey on the KD children during 10 years period from Jan. 1,1999 to Dec. 31,2008. SPSS 15.0 software was used to analyze the data. Results There were 93.75% of the survey forms came back. Five hundred and seventy - seven KD cases were reported from the 32 hospitals of 8 districts. The incidence of KD was of an increasing trend. It was 18 cases in 1999 ,while it was up to 122 cases in 2008. Male patients were 382 cases （66.2%） ,female patients were 195 cases （33.8%）. The ratio of male and female was 1.96 to 1. The age of patients varied from 58 days to 14 years,those under 5 years of age accounted of 88.73%. Fourteen （2.4%） cases were found to have the sequelae of coronary artery disease. The ratio of male and female was 3.67 ： 1. The younger the age,the higher the incidence of cardiac sequelae. The mainest cardiac sequelae was coronary artery ectasia. The time of visiting was （7.58 ±4.63） days after the onset. The KD children from 4 minority peoples including 50 cases accounted for 8.7%. The disease occurred all over the year,and had obvious season peak. Coronary artery lesions accounted for 63.26%. There was no death during acute period. The recurrence rate was 0. 5%. Conclusions The incidence of KD in Jilin is in an increasing trend. The age and gender distribution are not exactly the same to pre-vious reports. There are two seasonal peaks including summer and winter,which is different to previous reports of domestic, United State ,Japan.