云南省1997-2006年儿童川崎病临床流行病学调查研究  

Study on Clinical Epidemiology of Kawasaki Disease in Yunnan Province from 1997 to 2006

作　　者：马越明[1] 杜曾庆[1] 李利[2] 石明儒 万强 符丽玲[5] 王素[6] 尹兆青 杨运惠 杨元芝 冯协超 周玉康 

机构地区：[1]昆明市儿童医院心内科,昆明650034 [2]云南省第一人民医院儿科,昆明650032 [3]玉溪市医院儿科,云南玉溪653100 [4]楚雄州医院儿科,云南楚雄675000 [5]昆明市妇幼保健院儿科,昆明650021 [6]保山市第一人民医院儿科,云南保山678000 [7]德宏州医院儿科,云南德宏678400 [8]昭通市第一医院儿科,云南昭通657000 [9]个旧市医院儿科,云南个旧661400 [10]开远市医院儿科,云南开远661000 [11]文山州医院儿科,云南文山663000

出　　处：《实用儿科临床杂志》2008年第21期1651-1653,共3页Journal of Applied Clinical Pediatrics

基　　金：日本川崎病研究中心基金项目资助

摘　　要：目的对云南省近10a儿童川崎病(KD)发病情况进行流行病学调查,分析云南省川崎病发病、分布、流行特征及临床预后。方法采用日本-中国KD流行病学调查表对云南省136家设有儿科的县级以上医院,于1997年1月1日-2006年12月31日10a间住院的川崎病患儿进行填表调查。每5年进行1次,共进行2次。结果反馈调查信息共130家,调查表回收率95.6%,15个地区47家医院共报告KD患儿1662例;云南省儿童KD发病率1997年为0.351/万,而2006年达1.36/万,平均0.651/万;男女比为1.58:1.0;发病年龄2个月～14岁,5岁以下患儿占74.19%;患儿多集中于城市,但农村患儿有增加趋势;共11个少数民族,其患儿占6.4%;全年均可发病,无明显高峰季节;临床症状以发热5d以上最为常见;急性期冠状动脉改变为20.64%,其中冠状动脉扩张占冠状动脉改变的82.5%,冠状动脉瘤占17.5%,急性期无死亡病例,再发率为0.36%。结论云南省KD发病率呈增高趋势;在省内有明显的区域分布,高寒地区无病例报道;发病年龄5岁以下儿童居多,性别分布和冠状动脉损害与国内部分省市相近;KD冠状动脉病变已是儿童后天性心脏病的主要病因之一,急性期早期诊断治疗是避免发生后遗症的重要措施。Objective To investigate the epidemiological characteristics and clinical prognosis of Kawasaki disease （KD） in Yunnan province in recent 10 years. Methods The survey forms of Japan - China KD epidemiology were used and sent to 136 hospitals with the admission of pediatric in - patients at city level in Yunnan Province in order to conduct a survey on KD children during 10 - year period from January 1, 1997 to December 31,2006, totally for 2 times, once every 5 years. Results Ninety five point five percentage of the survey forms were collected and total 1 662 KD cases were reported from the 47 hospitals of 15 districts. The incidence rate of KD was of an increasing trend. It was 0.351 per 1 000 in 1997, while was up to 1.36 per 10 000 in 2006. Average was 0.651 per 1 000. The ratio of male and female was 1.58 to 1.0. The age of patients varied from 2 months to 14 years old, in which children under 5 years of age accounted for 74.19%. Most of KD children were from city, but the number from countryside was increasing. The KD children from total 11 minority peoples accounted for 6.4%. The disease occurred all the year round,without obvious season peak. Coronary artery lesion accountes for 20.64% , including ectasia（ 82. 5% ） and aneurysm（ 17.5% ）. There was no death case during acute period. And the recurrence rate was 0.36%. Conclusions The incidence of KD in Yunnan province has shown an increasing tendency. There is a distinct distribution among regions inside Yunnan province and no KD case reported from height and cold districts. The coronary artery lesion of KD has already been one of the main factors causing acquired heart disease in children. Thus, early diagnosis and treatment during acute period is an important measure to avoid any sequel.

关 键 词：川崎病 流行病学 发病率 冠状动脉病变 儿童 云南 

分 类 号：R725.4[医药卫生—儿科]