2000～2004年北京川崎病住院患儿流行病学调查  

Epidemiologic Study on Children with Kawasaki Disease in Beijing from 2000 to 2004

作　　者：张永兰[1] 杜忠东[1] 赵地[2] 杜军保[3] 鲁珊[4] 衣京梅[5] 侯安存[6] 周忠蜀[7] 丁国芳[8] 林瑶[1] 刘冲[1] 无 

机构地区：[1]首都医科大学附属北京儿童医院心脏中心,北京100045 [2]首都儿科研究所心内科,北京100020 [3]北京大学第一医院儿科,北京100034 [4]北京大学第三医院儿科,北京100083 [5]中国人民解放军总医院儿科,北京100853 [6]首都医科大学附属友谊医院儿科,北京100050 [7]卫生部中日友好医院儿科,北京100029 [8]中国协和医科大学北京协和医院儿科,北京100730 [9]北京小儿川崎病流行病学调查协作组

出　　处：《实用儿科临床杂志》2007年第1期12-15,共4页Journal of Applied Clinical Pediatrics

基　　金：首都医学发展基金联合攻关项目资助(2003-1018)

摘　　要：目的 进一步了解北京儿童川崎病（KD）的发病率及流行病学特点，并探讨其临床表现和急性期预后。方法 按照日本全国儿童KD调查及北京第1次KD流行病学调查方法，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，回顾性记录自2000年1月～2004年12月的所有KD患儿。结果 北京45家有儿科住院病床的医院参加调查，共计报告1107例患儿。5年KD发病率为40．9～55、1／10万5岁以下儿童，平均49．4（95％CI，46、6～52．4）／10万5岁以下儿童。2000～2004年发病率有逐年增高趋势（Pα〈0．05）。发病年龄1个月～13．8岁，中位年龄2．0岁，其中5岁以下占87．4％；男女发病比例为1、83：1；春、夏有2次发病高峰，以夏季最高，2000和2004年在2次高峰基础上冬季还有1次发病高峰。复发15例，复发率1．4％；有家族史2例，占0．2％。发热仍是最常见的临床表现，而多形性皮疹为最少见的临床特征，患儿急性期无死亡。结论 2000～2004年北京KD发病率较前5年升高，但仍低于日本。发病年龄和性别比例与以往报道相似，但季节分布不同，除每年春、夏2次流行高峰外，2000和2004年冬季出现第3个发病高峰。Objective To furtherly evaluate the epidemiologic feature of Kawasaki disease （KD） in Beijing and discuss the clinical feature and acute stage prognosis. Methods A questionnaire form and the 5^th revised diagnostic guidelines for KD were sent to all hospitals with pediatric in patient beds in Beijing and its suburbs. Pediatric hospitalizations for patients less than 18 years of age with a diagnosis of KD on the discharge record were selected during 5 - year period from January 2000 to December 2004. Results All 45 hospitals responded to the survey. A total of 1 107 children were enrolled. Based on population census data ,the annual incidence varied from 40.9 to 55.1 per 100 000 children less than 5 years of age with an average of 49.4 （95% CI, from 46.6 to 52.4 ） per 100 000 children less than 5 years of age. Their ages varied from 1 month to 13.8 years with a peak age of 1 year and 87.4% of children less than 5 years of age. The male to female ratio was 1.83 ： 1. There were 2 peaks in spring and summer for both girls and boys. In addition, a third peak was identified in October 2000, November and December 2004. Fifteen children recurred, with the recurrence rate of 1.4% ,2 children had family history（0. 2% ）. Febrile was the most common clinical featare,and pleomorphism rash was the most rare clinical feature. No death was reported in acute stage. Conclusions The incidence of KD in Beijing is on the rise as compared to the last 5 years. However, it is still lower than that reported in Japan. The age and gender distribution are similar to previous reports,but seasonal distribution is different with 2 peaks in spring and summer and another peak in winter in 2000 and 2004.

关 键 词：黏膜皮肤淋巴结综合征 发病率 流行病学 预后 

分 类 号：R725.4[医药卫生—儿科]