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Comparative study on Kawasaki disease between Japan and North America

日本与北美川崎病的比较研究

基本信息

批准号：
09044347
负责人：
KATO Hirohisa
金额：
$ 6.14万
依托单位：
Kurume University
依托单位国家：
日本
项目类别：
Grant-in-Aid for international Scientific Research
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1998
项目状态：
已结题

项目摘要

The objective of this project was to investigate of comparative evaluation between Japan and United States in terms of epidemiology, pathophysiology and treatment of Kawasaki disease. In the area of epidemiology, Yanagawa demonstrated the result of Japanese nationwide survey, especially the transition of patient's population, cardiac sequelae, mortality, recurrent rate and incidence of sibling case. Pathophysiological role of IgA plasma cells in vascular tissue during the acute stage was evaluated by Shulman and colleagues. Newberger and colleagues suggested that coronary arterial dimensions evaluated by echocardiography might be misclassified as normal in Kawasaki disease. Although the criteria of Japanese Ministry of Health is only published criteria the specifically define coronary artery abnormality in this disease, coronary artery dimensions in normal children have been shown to increase linearly with indices of body size, such as body surface area or body length. They introduced … More the data of body surfacarea corrected coronary dimensions. In the therapeutic area, Takahashi and colleagues introduced of low-dose wairfarin plus aspirin therapy in patients complicated with giant coronary aneurysm, which cause of myocardial infarction. Controversy has been persisted how to treat the patients who resisted initial gamma globulin treatment. Kato and colleagues demonstrated the clinical trail of steroid pulse therapy in such patients. Their current results shown the incidence of coronary artery lesion was not different between steroid pulse and gamma globulin therapy, however medical cost of steroid pulse therapy tend to be lower. Further investigation in this area should be required. Other topics of treatment were relatedof coronary artery involvements and its long-term outcome. Result of Japanese nationwide survey of catheter intervention was reported their importance as a new therapeutic strategies. Kato and colleagues reported that the presence of endothelial dysfunction at the site of regressed coronary aneurysm using direct infusion of aceylcholine. Less

本研究的目的是探讨日本与美国在川崎的流行病学、病理生理学及治疗方面的比较评估。在流行病学方面，柳川展示了日本全国调查的结果，特别是患者人群的变迁、心脏后遗症、死亡率、复发率和同胞病例的发生率。Shulman及其同事评价了急性期血管组织中伊加浆细胞的病理生理作用。Newberger及其同事认为，在川崎病患者中，超声心动图评估的冠状动脉直径可能被错误分类为正常。虽然日本卫生部的标准只是专门定义这种疾病中冠状动脉异常的标准，但正常儿童的冠状动脉尺寸已被证明与身体尺寸指数（如体表面积或体长）呈线性增加。他们介绍 ...更多信息体表面积数据校正冠状动脉尺寸。在治疗领域，Takahashi及其同事介绍了小剂量阿司匹林加阿司匹林治疗合并巨大冠状动脉瘤的患者，这些患者导致心肌梗死。如何治疗最初抵抗丙种球蛋白治疗的患者一直存在争议。Kato和他的同事证明了类固醇脉冲疗法在这些患者中的临床试验。他们目前的研究结果显示，类固醇脉冲和丙种球蛋白治疗的冠状动脉病变发生率没有差异，但类固醇脉冲治疗的医疗费用往往较低。应要求在这方面作进一步调查。其他治疗主题与冠状动脉受累及其长期结局有关。日本全国导管介入调查的结果报告了导管介入作为一种新的治疗策略的重要性。Kato及其同事报道了使用乙酰胆碱直接输注在消退的冠状动脉瘤部位存在内皮功能障碍。少