Surveillance of Kawasaki Disease in Taiwan and Review of the Literature

台灣川崎病之調查與文獻回顧

呂鴻基(Hung-Chi Lue) ； 菲立浦(Saji Philip) ； 陳銘仁(Min-Ren Chen) ； 王主科(Jou-Ko Wang) ； 吳美環(Mei-Hwang Wu)

《Acta Paediatrica Taiwanica》 45卷1期 (2004/02) Pp. 8-14

https://doi.org/10.7097/APT.200402.0008

摘要

川崎病又稱黏膜皮膚淋巴腺症候群,是多發於五歲以下兒童的一種急性疾病.臨床症狀包括發燒、皮疹、手足硬狀水腫、結膜充血、淋巴腺腫大及嘴唇潮紅等，另發生冠狀動脈病變，甚至心肌梗寒而死亡。在灣，於1976年發現首例，以後病例逐漸增加。著者等為調查川崎病之發生率及其他流行病學資料，於1987，1992，1994及2001年，特設計川崎病問鄭，調查台灣的18所至40所100床以上醫院的小兒科病例。著者等發現1976至2000年間，在台灣每年以1.15倍的比例在增加。二十五年間發生總病例數為8,339人。每萬五歲以下兒童發生例數做為發生率，1998年為最高，1998年為最，達54.9。男女比為1.6，二歲以下者佔25.3%，五歲或以上者14.9%。發生冠狀動脉病變者有2，152例，佔總例數的25.8%,死亡者12例，佔0.14%。著者又於1990至2000年間，每年以問卷，調查56,284至147，291位6至18歲學童。發現曾羅患過川崎病的學生，在1990年爲零，1991年28人，以後，即每年以1.24倍的比例在增加，2000年最高峰，達到每10萬學童有103.9人。著者等查閱世界文獻，發現日本的川崎病發生最早且最多，爲全世界之冠。臺灣的川崎病，發生的年代較慢於日本，但發生率僅次於日本，比全世界其他國家高，其增加趨勢及流行病學與日本相似。

關鍵字

冠狀動脈血管瘤 ； 流行病學 ； 川崎病 ； 台灣

並列摘要

Background. Kawasaki disease affects mainly children younger than five years, leading to coronary artery lesions, even to life-threatening myocardial infarctions. Since 1976, Kawasaki disease has occurred in thousands of children in Taiwan; some of them died.
Methods. Questionnaire forms for the survey of epidemiological features of Kawasaki disease were designed and sent to the hospitals of 100 or more beds in Taiwan, in 1987, 1992, 1994, and 2001, for retrospective reviews of their patients with Kawasaki disease encountered during 1976-2000. A school-based mass survey, on the prevalence of children with history of Kawasaki disease was conducted every year from 1990 to 2000.
Results. Since 1976, the number of Kawasaki disease patients increased, totaling to 8,267 patients in 2000. The ratio of the incidence increased by 1.15 times annually (Poisson regression), reaching the highest incidence of 54.9 per 100,000 children 5 years of age in 1998. Of them, 85.1% were under 5 years of age. The male-to-female ratio was 1.6. Coronary artery lesions were noted during acute, subacute and convalescent stages in 2S.80o of the patients. The fatality rate decreased from 0.40% to 0.06%. There was no student with history of Kawasaki disease among students surveyed in 1990. Subsequent school surveys showed the prevalence was 24.6 in 1991, 74.6 in 1996, then reached to 103.9 per 100,000 school children in 2000, with an annual increase of 1.24 times (Poisson regression).
Conclusions. In Taiwan, Kawasaki disease, first diagnosed in 1976, continued to occur with several outbreaks reaching to a peak incidence of 54.9 per 100,000 population less than 5 years of age in 1998. Epidemiological features of Kawasaki disease in Taiwan were similar to the Japanese experiences and the incidence was, next only to Japan, the second highest in the world.

並列關鍵字

coronary artery aneurysm ； epidemiology ； Kawasaki disease ； Taiwan