甘肃地区581例川崎病患儿流行病学特征分析  

Analysis of Epidemiological Characteristics of 581 Children with Kawasaki Disease in Gansu

作　　者：吴谨志 邓海梅 闵丽 王晋[1] 牛少敏[1] 刘亚红[1] 杨轶男[1] 董湘玉[1] WU Jinzhi;DENG Haimei;MIN Li;WANG Jin;NIU Shaomin;LIU Yahong;YANG Yinan;DONG Xiangyu(Department of Pediatric Cardiology,Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院小儿心血管科,甘肃省兰州市730030

出　　处：《中国全科医学》2021年第35期4499-4505,共7页Chinese General Practice

基　　金：甘肃省自然科学基金资助项目(17JR5RA222)。

摘　　要：背景川崎病(KD)是一种与冠状动脉病变(CAL)相关的系统性血管炎,可导致心肌病、心肌梗死甚至死亡。目前,KD发病率逐年攀升,已成为儿童获得性心脏病最常见的病因,显著影响成年后个体远期心血管疾病的发生。因此了解该病的流行病学特征以及影响因素对降低疾病发生率有重要意义。目的从人口学特征、时间分布和地域差异三方面探讨KD在甘肃地区的流行病学特征,以期为西部地区KD的管理和预防提供科学依据。方法选取2012—2019年兰州大学第二医院收治的581例KD患儿为研究对象,根据入选患儿1个月内CAL发生情况将其分为KD合并CAL组(CAL组)和无CAL组(NCAL组),根据发病年龄划分为≤1岁、>1~3岁、>3~6岁和>6岁4个年龄段。采用统一的调查表收集一般资料(年龄、性别、民族、发病时间等)、冠状动脉彩超结果。结果(1)人口学特征:581例KD患儿的中位发病年龄为1.9(1.2,3.2)岁,男∶女为1.9∶1,男性患儿在KD人群中的发病比例随年龄的增长呈下降趋势(χ^(2)趋势=5.100,P<0.05)。(2)时间分布:不同年份间KD病例数总体呈上升趋势(χ^(2)趋势=122.348,P<0.001);各季节患儿分布情况比较,差异有统计学意义(χ^(2)=12.418,P=0.006);春季患儿占比与年龄段呈负相关(r_(s)=-1,P<0.001),而秋季患儿占比与年龄段呈正相关(r_(s)=1,P<0.001)。(3)地域差异:结合甘肃地理位置、自然条件和区域经济社会发展现状,将甘肃省划分为河西、陇中、陇东、陇东南、民族五大区域;依据城镇居民日常生活开支、职工平均工资和社会经济发展水平等将甘肃省按发达程度由高到低划分为四类地区。陇中(χ^(2)趋势=86.011,P<0.001)、陇东南(χ^(2)趋势=23.848,P<0.001)和民族区域的KD病例数(χ^(2)趋势=17.463,P<0.001)均逐年增加;一类(χ^(2)趋势=54.551,P<0.001)、二类(χ^(2)趋势=20.586,P<0.001)、三类(χ^(2)趋势=14.844,P<0.001)和四类地区的KD病例数(χ^(2)趋�Background Kawasaki disease(KD)is a systemic vasculitis associated with coronary artery lesion(CAL),which can lead to cardiomyopathy,myocardial infarction and death.At present,the incidence of KD is increasing year by year and has become the most common cause of acquired heart disease in children,significantly affecting the occurrence of long-term cardiovascular events during adulthood.Understanding the epidemiological characteristics and influencing factors of the disease is of great significance for reducing the incidence of the disease.Objective To discuss the epidemiological characteristics of KD in Gansu from three aspects:demographic characteristics,time distribution and regional differences,in order to provide scientific basis for the management and prevention of KD in the western region.Methods The 581 children with KD admitted to the Lanzhou University Second Hospital from January 2012 to December 2019 were selected as the research objects.According to the CAL status of the selected children within 1 month,the children with KD were divided into KD combined with CAL(CAL group)and without CAL(NCAL group).According to the age of onset,they were divided into four age groups:≤1 year old,>1-3 years old,>3-6 years old and>6 years old.A unified questionnaire was used to collect general information(age,gender,ethnicity,time of onset,etc.)and thecoronary artery color Doppler ultrasound results.Results(1)Demographic characteristics:among the 581 hospitalized children,the median age of onset of KD was 1.9(1.2,3.2)years old.The ratio of male to female was about 1.9∶1 and the proportion of males decreased linearly with the increase of age(χ^(2)trend=5.100,P<0.05).(2)Temporal distribution:the overall number of KD showed an upward trend in different years(χ^(2)trend=122.348,P<0.001).There were significant differences in the distribution of KD cases in each season(χ^(2)=12.418,P<0.05).The proportion of children in spring was negatively correlated with their age groups(r_(s)=-1,P<0.001),of which in autumn was posit

关 键 词：川崎病 黏膜皮肤淋巴结综合征 流行病学研究 冠状动脉疾病 疾病特征 

分 类 号：R551.2[医药卫生—血液循环系统疾病]