1997～2001年四川省川崎病流行病学调查

目的了解四川省川崎病(KD)的发病率和流行病学特点。方法按日本川崎病研究中心提供的川崎病诊断标准、问卷表格和调查方法,对四川省内设有儿科病床的医院进行问卷调查。收集1997年1月1日～2001 年12月31日的川崎病患儿住院资料。结果调查全省212所医院,调查表回收率达到91．5％,全省共报告了KD 患儿1811例,符合川崎病诊断标准1511例。1997～2001年<5岁儿童患病率分别为4．26／10万、5．21／10万、8．57／ 10万、7．70／10万、9．81／10万,5年平均发病率为7．06％。男女之比为1．66:1,发病高峰为1～2岁,17．0％的川崎病患儿有心脏冠脉损伤。典型病例占94．6％,使用静脉丙种球蛋白(IVIG)治疗者占70．9％。结论 1997～2001年四川省5年川崎病的发病率低于日本,与国内其他地区KD流行病学资料相比,发病率高于江苏、陕西和广东,低于北京,有逐年增高趋势。     

云南省1997-2006年儿童川崎病临床流行病学调查研究

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。     

吉林省1999-2008年小儿川崎病流行病学调查

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...     

霍奇金淋巴瘤25例临床分析

霍奇金淋巴瘤（HL）是淋巴系统恶性肿瘤，为儿科常见的恶性肿瘤之一。在欧美等发达国家HL占淋巴瘤的50％，而在中国占7．9％～18％。男性患儿多于女性，男女比率在欧美为2：1，亚洲为3．5：1．0，在发展中国家7岁以下患儿男女比率可达10：1。儿童时期是HL发病的高峰阶段。我院儿科2003—2009年共收治25例HL，现对其进行回顾性总结分析，报道如下。     

自贡市川崎病流行病学调查研究

目的了解自贡市川崎病发病情况、流行病学及治疗现状。方法按日本川崎病研究课题组“川崎病诊断标准”制定统一调查表，在自贡市县、市级医院选择1997年1月-2001年12月儿科住院川崎病患者进行调查，对发病年龄、性别、地区、季节、心血管并发症等进行分析。结果5年间川崎病发病共152例，未发生流行现象，男性发病占58．55％，其年龄：＜1岁占4．6％，1～4岁占58％，以3～5月份为高峰，9～12月份发病最低，有冠状动脉病变占19．48％。结论川崎病在我市春季发病率高于秋季，男性略高于女性，发病年龄高于日本及国内报道，冠状动脉病变率与各家报道相似，农村发病占65．13％。提示我市农村发病高于城市，是否与农村经济、营养状况、免疫功能低下、医疗卫生条件较差有关。由于川崎病导致心脏病发病率仍较高，作为基层医师不但要重视早诊早治，还要重视定期随访。     

川崎病研究新进展

川崎病 (KawasakiDisease,KD)自1 96 7年川崎富作医生报告以来 ,世界各地均有报道。经过近 4 0年来的研究 ,其流行病学、预防、诊断、治疗方面均有许多新的进展 ,现综述如下。1　病因及流行病学研究进展日本从 1 970年开始进行两年一次的全国流行病学调查 ,已进行了 1 4次 ,报道患儿总数为 1 4 0 873人 ,分别于1 979、1 982、1 986年有过 3次大流行。1 995— 1 996年第 1 4次全国性的流行病学调查共检出患儿 1 2 5 31例 ,发病季节以冬夏为主 ,发病高峰年龄为 6～ 1 1个月 ,病死率 0 0 8%。男 :女 =1 37∶1 ,儿童冠状动脉受累者达 1 2 % …     

儿童和青少年原发性夜遗尿症患病率现状和回顾性调查

目的对河南省儿童和青少年作原发性遗尿症（PNE）患病率调查，为儿童和青少年的保健与疾病防治提供参考依据。方法从2003年7月~2004年12月，随机选取河南省7个城市管辖区中小学的5～18岁儿童和青少年进行PNE流行病学调查。采用无记名调查问卷的方式。对目前无夜间尿床儿童，要求父母回忆其停止夜间尿床的年龄。结果实际发放调查问卷11799份，回收10383份，有效问卷10088份，有效回收率为85．5％。现况调查5～18岁儿童PNE总体患病率为4．07％（95％可信区间3．68～4．46）。5岁患病率为11．83％（95％可信区间9．25～14．41），12岁降为1．72％（95％可信区间1．10～2．43），15岁时降为1．21％（95％可信区间0．50～1．96），以后稳定于1．0％左右。男性PNE患病率为4．57％（95％可信区间4．00～5．14），与女性3．56％（95％可信区间3．04~4．08）之间的差异有呈著性意义（P〈0．05）。男女PNE患病率均具有随年龄的增加而显著降低趋势。回顾性调查5岁时PNE患病率为9．6%，10岁时为1．02％，以后各年龄段PNE降至1．0％以下。现状调查时男性、女性和总体PNE患病率均高于回顾性调查。结论回顾性调查和现状调查均显示5～7岁儿童仍有10％左右的儿童患有PNE，是影响儿童生活质量的主要疾病之一，应引起社会关注。     

1997～2000年与1988～1996年北京地区儿童1型糖尿病发病率比较

目的 了解1997年～2000年北京地区儿童1型糖尿病发病翠,与1988～1996年的调查结果进行比较。方法 按照世界卫生组织(WHO)标准的捕获再捕获调查法,通过2个渠道搜集所有1997年1月1日～2000年12月31日新发病的北京地区15岁以下1型糖尿病儿童,按人口统计资料计算发病率,按2000年人口普查公布的结果计算年龄校正的发病率。泊松分布公式计算发病率的可靠性(95％可信限),卡方检验法检验发病率差异的显著性。结果 1997～2000年间,北京地区儿童1型糖尿病的年发病率波动在0．759／10万一1．215／10万之间,平均年发病率为1．014／10万,95％可信限为0．98／10万一1．16／10万。与1988～1996年比较,年粗发病率差异无显著性;按2000年普查资料,以年龄矫正后,发病率分别为o．83／10万和0．86／10万,差异无显著性。年龄比较依然为10～14岁组发病率高(P=0．002)。虽然女性较男性发病率高,但与北京地区前述的报告不同,男女发病率比较差异无显著性。结论1997～2000年北京地区儿童1型糖尿病平均年发病率为1n14／1n百导IORR～1q06正谰杏结果比较未见明显增高。     

传染病

510036 一起农村甲型病毒性肝炎流行的血清学调查孙永德等中华预防医学杂志19(3):140～142,1985 ①该村发病率为6.3％,发病年龄9个月～10岁,以4～6岁组发病率最高为41.4％,1～3岁为35.6％,7～10岁组为10.4％,零岁组为4.4％。8～9月为流行高峰。发病地区呈灶性分布并顺序流行;②用免疫粘连血球凝集试验检测病人急性期,恢复期双份     

200例海安县儿童重症哮喘流行病学及临床特征分析

目的：分析归纳海安县儿童重症哮喘的流行病学特点和临床特征。方法回顾性分析2005年1月至2013年12月收治于我院儿科的200例重症哮喘患儿,分析其流行病学特点和临床特征。结果(1)流行病学特征：男女比例为1．44∶1,以男孩发病率相对较高。发病年龄以3~5岁相对为高,占54%。发病季节以冬季为主,占37．5%。发病诱因主要是是呼吸道感染,占60%。不同年龄段发病诱因不同,除外呼吸道感染,5岁以下儿童主要诱因为季节变化,5岁及以上儿童则为接触过敏原和运动。(2)患儿经过一般对症治疗、β2受体激动剂、糖皮质激素等综合治疗后,症状明显缓解。(3)200例患儿,1例因就诊不及时,并发呼吸衰竭抢救无效死亡;2例自动出院,其余197例患儿(98．5%)均好转出院。住院天数为(10．4±2．1)d,好转天数(2．8±1．2)d。结论海安县儿童重症哮喘以男孩发病率相对较高,发病年龄以3~5岁多见,发病季节以冬季为主,呼吸道感染为不同年龄段最常见诱因,其他发病诱因不同年龄段有差异。重症哮喘患儿若及早诊治、快速平喘和去除诱因,预后良好。     

Epidemiologic picture of Kawasaki disease in Beijing from 1995 through 1999

OBJECTIVE: Kawasaki disease (KD) is supposed to be more common in the Asian race. The incidence in Japan is 10-fold higher than rates reported from western countries. This study sought to evaluate the epidemiologic picture of KD in Beijing and its suburbs. METHOD: A questionnaire form and diagnostic guidelines for KD were sent to all hospitals with pediatric inpatient beds throughout Beijing and its suburbs. Pediatricians were asked to review the medical records and report all patients with KD diagnosed during the 5-year period from January, 1995, through December, 1999. RESULTS: A total of 710 patients with KD were reported from 37 (95%) of 39 hospitals with pediatric inpatient beds. The incidences of KD for each year of the study were 18.2 (1995), 21.1 (1996), 18.6 (1997), 30.6 (1998) and 27.8 (1999) per 100,000 children <5 years of age. The male:female ratio was 1.7:1. The age at onset ranged from 1 month to 13.4 years (median, 2.3 years), with 85.2% <5 years old. The disease occurred more frequently in spring and summer and less frequently in autumn and early winter. Lymph node enlargement was the least common clinical sign, and its incidence decreased from 1995 to 1999. Cardiac abnormalities were found in 21.5% of patients and were more prevalent in patients diagnosed 10 days or longer after the onset. No patients died in the acute stage. CONCLUSION: The incidence of KD in Beijing is lower than that reported in Japan, similar to the incidence in the United States and higher than in other western countries. The age and gender distribution and increasing trend in incidence are similar to those in previous reports, but seasonal distribution is unique.     

Epidemiological survey of Kawasaki disease in Sichuan province of China

OBJECTIVES: To investigate the incidence and epidemiological characteristics of Kawasaki Disease (KD) in Sichuan province of China. METHODS: The questionnaire and diagnostic guideline for KD provided by Japan Kawasaki Disease Research Center (JKDRC) were used for the questionnaire investigation in pediatric departments of all hospitals in Sichuan province for data of KD diagnosed in their hospitals from 1 January 1997 to 31 December 2001. RESULTS: Of the 212 hospitals investigated, 91.5% responded to the questionnaire investigation, with a total of 1811 cases of KD identified. The incidence per 100,000 children <5 years of age was 4.26 in 1997, 5.21 in 1998, 8.57 in 1999, 7.70 in 2000 and 9.81 in 2001, respectively. The average incidence throughout the 5 years was 7.06 per 100 000. The ratio of male to female was 1.62 : 1. The age distribution showed a peak near 1-2 years of age. Cardiac sequelae were seen in 17.0% of the patients. Only 66.2% patients with KD had been treated with intravenous immunoglobulin. CONCLUSION: The incidence of KD in Sichuan province was lower than that reported in Japan and Beijing, higher than that in Guangdong, Jiangsu and Shanxi province of China.     

Epidemiologic study on Kawasaki disease in Beijing from 2000 through 2004

A hospital-based survey of Kawasaki disease was performed in all 45 hospitals with in-patient beds in Beijing during the 5-year period from 2000 through 2004. A total of 1107 patients were enrolled, with an annual incidence varying from 40.9 to 55.1 per 100,000 children <5 years of age. The incidence of coronary complications was 20.6% in the acute stage, and 6.9% in the 1-2 month follow-up.     

静脉丙种球蛋白无反应性川崎病的治疗及危险因素分析

目的探讨首次丙种球蛋白静脉注射(IVIG)无反应性川崎病(KD)的发生率及危险因素,及其再治疗方法的选择。 方法总结2000—2004年北京45家医院KD患儿的临床资料,IVIG无反应性定义为首次IVIG治疗36h后体温仍超过38.5℃。 结果1107例患儿纳入研究对象,1092例有急性期治疗资料,1052例(96.3%)接受IVIG治疗,135例对首次IVIG治疗无反应,发生率12.8%(135/1052)。Logistic回归分析发现血沉、GPT、WBC、发病至用IVIG的时间、血浆白蛋白及IVIG治疗剂量,是IVIG无反应性的独立危险因素(P<0.05)。对IVIG无反应者8例给第2剂2g/kg IVIG,5例热退;114例给1g/kg剂量IVIG治疗,35例(30.7%)热退;11例给400~600mg/kg IVIG,1例(9.1%)热退;2例给糖皮质激素,2例均热退。4种再治疗方法间比较,差异有统计学意义(P=0.015)。第2剂2g/kg IVIG治疗较其它再治疗所需进一步IVIG或激素治疗次数少,体温恢复快。 结论约12.8%KD患儿对初次IVIG治疗无反应。血沉、WBC和GPT、血浆白蛋白、IVIG使用方法及起病至用IVIG的时间,是IVIG无反应的独立危险因素。对初次IVIG无反应患儿推荐使用第2剂2g/kgIVIG,对2次2g/kg IVIG治疗仍无效者可以选用糖皮质激素治疗。     

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目的探讨首次丙种球蛋白静脉注射(IVIG)无反应性川崎病(KD)的发生率及危险因素,及其再治疗方法的选择。方法总结2000—2004年北京45家医院KD患儿的临床资料,IVIG无反应性定义为首次IVIG治疗36h后体温仍超过38·5℃。结果1107例患儿纳入研究对象,1092例有急性期治疗资料,1052例(96·3%)接受IVIG治疗,135例对首次IVIG治疗无反应,发生率12·8%(135/1052)。Logistic回归分析发现血沉、GPT、WBC、发病至用IVIG的时间、血浆白蛋白及IVIG治疗剂量,是IVIG无反应性的独立危险因素(P<0·05)。对IVIG无反应者8例给第2剂2g/kg IVIG,5例热退;114例给1g/kg剂量IVIG治疗,35例(30·7%)热退;11例给400~600mg/kg IVIG,1例(9·1%)热退;2例给糖皮质激素,2例均热退。4种再治疗方法间比较,差异有统计学意义(P=0·015)。第2剂2g/kg IVIG治疗较其它再治疗所需进一步IVIG或激素治疗次数少,体温恢复快。结论约12·8%KD患儿对初次IVIG治疗无反应。血沉、WBC和GPT、血浆白蛋白、IVIG使用方法及起病至用IVIG的时间,是IVIG无反应的独立危险因素。对初次IVIG无反应患儿推荐使用第2剂2g/kgIVIG,对2次2g/kgIVIG治疗仍无效者可以选用糖皮质激素治疗。     

Risk of coronary abnormalities due to Kawasaki disease in urban area with small Asian population

The epidemiology of Kawasaki disease in the six-county Chicago metropolitan area (total population, greater than 7,100,000 inhabitants) was characterized by identifying cases, with onset occurring from 1979 to 1983, inclusively, that had been studied by echocardiography. A retrospective survey of the records from pediatric echocardiographic laboratories and pediatric cardiologists at teaching hospitals, as well as a random sample survey of nonteaching hospitals with pediatric beds in the metropolitan area, was carried out. A total of 190 cases were identified, yielding an annual mean minimum incidence of 5.95 per 100,000 children less than 5 years old. Cases occurred endemically with superimposed spring clusters in 1980 and 1983. As seen in other studies, the male-female ratio was 1.58:1, and the peak incidence occurred in children between 1 and 2 years old, with 85% of cases occurring in children under 5 years of age. The racial distribution of cases was as follows: whites, including Hispanics, 62%; blacks, 32%; Asians, 5%; and half-white/half-Asian, 1%. Asians were slightly overrepresented in that they made up only 1.7% of the study area population. The annual minimum incidence for Asian Americans was 24.4 per 100,000 children less than 5 years old; this rate was significantly greater than those for the other racial groups. Although few cases were observed in Japanese-American children, the calculated annual minimum incidence in this small group was approximately 44 per 100,000 children less than 5 years old. The highest incidence was observed in several suburban Chicago zip code areas, where annual rates as high as 84.7 per 100,000 children less than 5 years old were documented. Coronary artery abnormalities were diagnosed by echocardiography in 30 (16%) of 190 cases; the male-female ratio of patients with such abnormalities was 2.75:1. Whites and children under 1 year of age demonstrated the highest incidence of coronary artery abnormalities. White children under 1 year of age appeared to be at particularly high risk for development of coronary abnormalities, with 11 (41%) of 27 white infants manifesting such findings by echocardiography. These infants may represent a subgroup of patients who would benefit particularly from therapy with intravenous gamma globulin for prevention of coronary abnormalities and who require particularly close follow-up care.     

Insulin dependent diabetes in under 5 year olds.

Insulin dependent diabetes mellitus presenting in children under five years old exhibits several clinical and management features that differ from diabetes presenting in older children. In this review of the current population of the Oxford children''s diabetes clinic, children with diabetes diagnosed aged 0- less than 5 years are compared with those diagnosed aged 5- less than 10 years to illustrate these differences. The mean annual age specific incidence of diabetes for children aged 0- less than 5 is 9.9/100 000 compared with 13.8/100 000 for the children diagnosed aged 5- less than 10. Although children with diabetes currently aged less than 5 comprise only 8% of the clinic population, such children ultimately make up 41% of the total number of children with diabetes aged under 15 attending the clinic. Diabetes diagnosed in children under the age of 5 seems to have increased in incidence over the past 10 years, exhibits a male preponderence (1.5:1), and shows an unusual seasonal variation in incidence with an autumn/early winter trough, late winter/early spring peak, and the absence of mid-summer trough seen in other age groups. First degree family history was positive in 16% of children diagnosed under the age of 5 compared with 10% of the group diagnosed aged 5- less than 10. In none of these children was the mother the affected relative.