Epidemiological Evidence of Seasonality in Kawasaki Disease in Taiwan

台灣地區川崎病的季節集中趨勢：流行病學觀點

林銘泰(Ming-Tai Lin) ； 王主科(Jou-Kou Wang) ； 邱舜南(Shuenn-Nan Chiu) ； 陳俊安(Chun-An Chen) ； 呂鴻基(Hung-Chi Lue) ； 吳美環(Mei-Hwan Wu)

《Acta Cardiologica Sinica》 23卷1期 (2007/03) Pp. 29-34

摘要

背景　當疾病的發生率呈現明顯的季節性分布時，常暗示環境因素在致病機轉中佔有一重要的角色。川崎病(Kawasaki disease)是一種原因未明的血管炎，好發於年紀較小的兒童，它有以下五個特徵：發燒持續五天以上、兩側非化膿性結膜炎、口腔黏膜發紅、四肢肢端皮膚變化、紅疹及頸部淋巴結。一般相信川崎病(Kawasaki disease)的發病具有多重因子，然而它的季節性在台灣未曾被以流行病學的方法檢視過。
方法　從過去的文獻我們擷取出1996到2002年之間川崎病(Kawasaki disease)的流行病學資料，基本上這些資料是從國民健康保險的資料庫中取得，其中未滿18歲住院且符合川崎病診斷標準(ICD: 446.1)的病人才列入統計，然後這些資料將被轉型成累積分布曲線；我們應用Kuiper's test來分析這條曲線並研究其是否有明顯的季節性分布。
結果　從1996年到2002年間每年的累積分布曲線(cumulative distribution curve)被畫出；運用Kuiper's test的結果發現在研究期間，每一年的季節集中性均大於百分之九十九，意即有明顯的季節趨勢。
結論　流行病學的分析結果顯示，川崎病在台灣有明顯的季節分布，這也支持了過去的理論，川崎病可能是向某些病原體所誘發的。進一步針對致病病原的研究是有相當的必要性。

關鍵字

季節性 ； 川崎病 ； 流行病學 ； Kuiper's試驗

並列摘要

Background: Seasonality in the occurrence of a disease often suggests the presence of environmental factors in its etiology. Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that occurs predominantly in infants and young children. KD is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, skin rash, and cervical lymphadenopathy. It is believed to be a multifactorial disease, and its seasonality had never been examined epidemiologically.
Aim: We sought to examine the seasonality of KD in Taiwan by using a higher-power statistical method.
Method: Epidemiologic data of Kawasaki disease in Taiwan between 1996 and 2002 were taken from a published paper. Basically, the database came from the National Health Insurance data and hospitalized patients who were under 18 years old and met criteria listed for KD (ICD-9-CM code: 446.1) were selected. The data were transformed and analyzed in the form of cumulative distribution curve. Kuiper's test was applied to test the seasonality, and differences were deemed significant at a p value ＜ 0.05.
Results: The cumulative distribution curve for KD in Taiwan was developed for each year. The results of Kuiper's test for seasonality in each year between 1996 and 2002 showed statistical significance for all years examined, (p＜0.01) and ascertained the presence of seasonality for KD.
Conclusion: Epidemiological analysis of KD patients in Taiwan confirmed the seasonality of this disease. This will support the theory that certain infectious agents may cause KD. Extended survey of the ubiquitous etiology is advised.

並列關鍵字

Seasonality ； Kawasaki disease ； Epidemiology ； Kuiper's test