Large scale epidemiologic study on incidence and factors influencing prognosis of Kawasaki disease

川崎病发病率及影响预后因素的大规模流行病学研究

• 批准号: 12470100
• 负责人: YANAGAWA Hiroshi
• 金额: $ 10.3万
• 依托单位: Saitama Prefectural University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12470100/
• 关键词: Kawasaki disease; Epidemiology; Gamma-globulin; Prognosis; Recurrence; cardiac sequelae; Nationwide survey; Database of patients; γグロブリン治療; 予後; 罹患率; ガンマグロブリン治療

(1) Epidemiologic analysis of the incidence of Kawasaki diseaseAs a results of the nationwide survey of Kawasaki disease, 15,314 patients were reported in 1999 and 2000. The epidemiologic and clinical pictures of these patients were analyzed. The time space relationship of the incidence was found.Four-hundred forty nine deaths were reported from 1970 to 1998. The fatality rate was 0.29 % with male/female ratio 1.5. The fatality rate in children < 1 years old was 3.9 times higher than 1 year old and over. The fatality rate decreased after the increase of the patients treated with gamma globulin.(2) Analysis of risk factors of cardiac sequelaeFactors associated with the cardiac sequelae after 1 month and 1 year of onset were analyzed. In 1 month after onset, age (< 1 year), recurrence and increase of noutrophile leucocyte were risk factors. In 1 year after onset, recurrence, increase of leucocyte and neutrophile leucocyte were risk factors. Administration of high dose IVGG prevented the cardiac sequelae after 1 year of onset.Factors associated with recurrence were age (<1 year old), presence of cardiac sequelae, high dose of IVGG treatment at initial episode.(3) Development of data base of Kawasaki disease patientsData base of 169,000 patients were constructed. The data base will be applicable to the evaluation of the long term prognosis of the patients.

(一)川崎病发病流行病学分析1999年和2000年全国川崎病调查结果共报告川崎病患者15314例，对这些患者的流行病学和临床情况进行分析。找出发病的时空关系。1970年至1998年共报告死亡449例，病死率为0.29%，男女之比为1.5。 1岁以下儿童的死亡率是1岁及以上儿童的3.9倍。病死率随丙种球蛋白治疗患者数量的增加而下降。(2)心脏后遗症危险因素分析分析发病1个月和1年后心脏后遗症的相关因素。发病后1个月内，年龄（<1岁）、复发、中性粒细胞增多是危险因素。发病后1年内复发、白细胞及中性粒细胞增多是危险因素。发病1年后给予高剂量IVGG可预防心脏后遗症。与复发相关的因素有年龄（<1岁）、是否有心脏后遗症、首发时高剂量IVGG治疗。（3）川崎病患者数据库的建立构建了169,000名患者的数据库。该数据库将适用于评估患者的长期预后。

项目成果

中村好一: "川崎病全国調査からみた医療施設の特性と心後遺症"小児科診療. 63. 671-676 (2000)

Koichi Nakamura：“川崎病全国调查的医疗设施和心脏后遗症的特征”儿科学 63. 671-676 (2000)。

Oki I: "A multicenter collaborative study on the risk factors of cardiac sequelae due to Kawasaki disease : a one-year follow-up study"Acta Paediatr. 89. 1435-1438 (2000)

Oki I：“川崎病心脏后遗症危险因素的多中心合作研究：一年的随访研究”Acta Paediatr。

屋代真弓: "過去15回の全国調査で報告された川崎病死亡例の疫学特性"日本小児科学会誌. 104・12. 1179-1183 (2000)

Mayumi Yashiro：“过去 15 次全国调查中报告的川崎病死亡的流行病学特征”，日本儿科学会杂志 104・12（2000 年）。

Hirata S: "Incidence rate of recurrent Kawasaki disease and related risk factors : from the results of nationwide surveys of Kawasaki disease in Japan"Acta Paediatr. 90. 40-44 (2001)

Hirata S：“川崎病复发率和相关危险因素：来自日本全国川崎病调查结果”Acta Paediatr。

Oki I: "A multicenter collaborative study on the risk factors of cardiac sequelae due to Kawasaki disease : a one-year follow-up study"Acta Paediatr. 89. 1435-8 (2000)

Oki I：“川崎病心脏后遗症危险因素的多中心合作研究：一年的随访研究”Acta Paediatr。