The incidence of pediatric rheumatic diseases: results from the Canadian Pediatric Rheumatology Association Disease Registry.
The incidence of pediatric rheumatic diseases: results from the Canadian Pediatric Rheumatology Association Disease Registry.
复制标题
儿科风湿病的发病率：加拿大儿科风湿病协会疾病登记处的结果。
DOI：
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发表时间：
1996
影响因子：
3.9
通讯作者：
Alan M. Rosenberg
中科院分区：
文献类型：
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作者：
Peter N. Malleson;Fung My;Alan M. Rosenberg
目的
确定加拿大儿科风湿病专家所见的儿童风湿病的发病率和肌肉骨骼疾病的频率。
方法
应用从ICD-9修改的标准化疾病定义和疾病代码，来自加拿大所有10个省的13个中心的加拿大儿科流变学协会的成员登记了1991年5月1日至1993年4月30日期间发现的所有新患者。患者数据包括年龄、性别、种族、出生日期、疾病发作日期、诊断日期和诊断代码（可输入多个诊断）。为了最大限度地减少右删失的偏倚，仅使用1991年5月1日至1992年10月31日之间发病的患者的数据来估计疾病发生率。
结果
共登记了3362份记录，共计3683项诊断（92项单独诊断）。每年转诊至儿科风湿病中心的中位转诊率为每10万名高危儿童中有26名。所有形式的慢性关节炎的患病率为23.3%，结缔组织疾病为6.5%，所有形式的血管炎为6.1%。从整个登记处计算的每年每10万名高危儿童的最低发病率为：各种形式的慢性关节炎4.08（95% CI：3.62，4.60），系统性红斑狼疮0.28（0.18，0.45）和皮肌炎0.15（0.09，0.29）。如果不包括转诊率低得不成比例的两个省（阿尔伯塔和魁北克），则得到的数字要高得多。
结论
儿科风湿病学家看到各种疾病的儿童。重要的是，儿科风湿病学培训反映了这一点，而不是只关注经典的炎性关节病。最低发病率数据显示，加拿大每年有大量儿童患上可能终身的慢性风湿性疾病。这些数据应该有助于计划提供儿科风湿病服务，不仅在加拿大，而且在其他发达国家。
OBJECTIVE
To determine the incidence of rheumatic diseases in children, and the frequency of musculoskeletal disorders seen by pediatric rheumatology specialists in Canada.
METHODS
Applying standardized disease definitions and disease codes modified from ICD-9, members of the Canadian Pediatric Rheumatology Association from 13 centers in all 10 provinces of Canada registered all new patients seen between May 1, 1991 and April 30, 1993. Patient data included age, sex, ethnicity, date of birth, date of disease onset, date of diagnosis, and diagnostic codes (more than one diagnosis could be entered). To minimize the bias of right censoring, only data from patients with disease onset between May 1, 1991 and October 31, 1992 were used to estimate disease incidence.
RESULTS
3362 records totalling 3683 diagnoses (92 separate diagnoses) were registered. Median referral rate per year to a pediatric rheumatology center was 26 per 100,000 children at risk. The frequency of diseases seen was 23.3% for all forms of chronic arthritis, 6.5% for connective tissue diseases, and 6.1% for all forms of vasculitis. The minimum incidence rates per 100,000 children at risk per year calculated from the whole registry were: all forms of chronic arthritis 4.08 (95% CI: 3.62, 4.60), systemic lupus erythematosus 0.28 (0.18, 0.45), and dermatomyositis 0.15 (0.09, 0.29). Substantially higher figures were obtained if the figures were calculated excluding the 2 provinces (Alberta and Quebec) that had disproportionately low referral rates.
CONCLUSION
Pediatric rheumatologists see children with a wide variety of diseases. It is important that pediatric rheumatology training reflects this and does not focus exclusively on the classical inflammatory arthropathies. The minimum incidence data show there are substantial numbers of children developing potentially lifelong chronic rheumatic diseases each year in Canada. These data should be helpful in planning the delivery of pediatric rheumatology services not only in Canada, but also in other developed countries.