1995～1999年北京住院小儿川崎病流行病学调查

目的了解北京小儿川崎病的发病率及流行病学特点,并与其他地区比较。方法按照日本全国小儿川崎病调查方法,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和川崎病的诊断标准,回顾性记录自1995年1月至1999年12月期间诊断为川崎病的所有患儿。参加调查人员均为小儿心血管医生或是高年资儿科医生,由2名高年资儿科医生监督确保调查严格按照研究方案进行。心血管并发症是指川崎病起病1个月内发生的经超声心动图或冠脉造影证实的心脏扩大,冠状动脉扩张、狭窄或阻塞,心肌梗塞,或心脏瓣膜损害。结果北京39家有儿科住院病床的医院中,37家(95％)参加调查,共计报告710例患儿,1995～1999年北京5岁以下小儿川崎病年发病率分别为18．2／10万、21．1／10万、18．6／10万、30．6／10万和27．8／10万。男女发病比例为1．7：1,发病年龄从1月至13．4岁(平均2．3岁),其中5岁以下占85．2％。本病在春、夏两季发病较多,秋冬较少。淋巴结肿大是最少见的临床症状,且其发生率自1995至1999年逐年降低。21．5％的患儿发生心血管并发症,见于起病后10或10d以上才确诊的患儿,患儿急性期无死亡。结论北京地区川崎病的发病率低于日本,而与美国的发病率相当,但高于其他西方国家。发病年龄和性别比例以及发病率逐年趋势与以往报道相似,但季节分布不同,

Epidemiologic study of admitted children with Kawasaki disease in Beijing from 1995 to 1999

OBJECTIVE: To evaluate the epidemiologic picture of Kawasaki disease (KD) in Beijing and its suburbs. METHODS: A questionnaire form and diagnostic guideline 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, to December, 1999. RESULTS: A total of 710 patients with KD were reported from 37 (95%) of 39 hospitals with pediatric inpatient beds. The incidence rates of KD 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 (with median of 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. CONCLUSIONS: 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 those 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.