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Epidemiologic features of Kawasaki disease in Shanghai from 2003 through 2007

Chinese Medical Journal 2010年第19期123卷 2629-2634页

作者： MA Xiao-jing YU Cen-yan HUANG Min CHEN Shu-bao HUANG Mei-rong HUANG Guo-ying Children's Hospitai of Fudan University Shanghai 201102 China Children's Hospital of Shanghai Jiao Tong University Shanghai 200040 China Shanghai Children's-Medical Center Shanghai 200127 China Xinhua Hospital of Shanghai Jiao Tong University Shanghai 200092 China Institute of Biomedical Science Fudan University Shanghai 200032 China Pediatric Heart Center Children's Hospital of Fudan University 399 Wan Yuan Road Shanghai 201102 China

Background The epidemiologic pictures of Kawasaki disease （KD） in Shanghai from 1998 through 2002 were reported while the current status of KD in the following five years remains unknown. Methods A questionnaire form and diagnostic guidelines for KD were sent to 50 hospitals providing pediatric medical care in Shanghai, China. All patients with KD diagnosed during January 2003 through December 2007 were recruited. Results In total, 1187 cases of KD were enrolled. The incidence of KD was 36.78 to 53.28 （mean 46.32±6.51） per 100 000 children under the age of 5 years between 2003 and 2007, which was higher than the year from 1998 to 2002 of （27.32±7.11） per 100 000, （t=4.406, P=0.002）. Ages at onset ranged from 12 days to 13.6 years （median 1.8 years）. It occurred more frequently in summer and spring. Coronary arterial lesions （CAL）, defined as ectasia or aneurysm, accounted for 19.8% （232 cases）. Flattened or inverted T wave was the most frequent finding （194 cases, 20.5%） by electrocardiogram. Intravenous gamma-globulin was administrated to 1028 cases （86.6%）. The occurrence of CAL seemed less frequent in the patients received gamma-globulin from day 5 to day 9 after the onset with the regimen of 1000 mg/kg once or 1000 mg/kg twice. Conclusions The incidence of KD was increasing in Shanghai. Treatment with intravenous gamma-globulin from day 5 to day 9 after the onset with the regimen of 1000 mg/kg once or 1000 mg/kg twice resulted in less coronary seauelae.

关键词： Kawasaki disease mucocutaneous lymph node syndrome coronary arterial lesions epidemiology incidence

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Follow-up of coronary artery lesions caused by Kawasaki disease and the value of coronary angiography

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Chinese Medical Journal 2002年第5期115卷 681-684,148页

作者：龚方戚白石裕比湖桃井真里子浙江大学医学院附属儿童医院浙江310003 Department of Pediatrics Jichi Medical schoolMinamikawachi

OBJECTIVE: To investigate the course of coronary artery lesions caused by Kawasaki disease, and the value of coronary angiography (CAG) and two-dimensional echocardiography (2-D Echo) in the evaluation and follow-up of coronary artery lesions. METHODS: Eighty seven patients with coronary artery lesions caused by Kawasaki disease from 1979 to 1997 were retrospectively analyzed. One hundred and sixty-seven CAGs were performed in 87 patients during follow-up. CAG was repeated every 1-3 years in each patient until complete regression was confirmed. 2-D Echo was performed before CAG each time. The longest period of follow-up was 16 years and 6 months. Patients were treated with aspirin or aspirin and warfarin. RESULTS: During follow-up, the coronary artery lesions regressed in 48/87 (55%) patients, however, they developed into severe coronary artery lesions in 6/87 (7%) patients in whom coronary artery bypass surgery was performed. The coronary artery aneurysm regressed in some patients, while stenotic lesions remained or developed. The ratio of coronary artery stenotic lesions to aneurysms increased progressively. This study showed that Echo diagnosis of coronary artery lesions has 'false positives' and 'false negatives'. Only 76% of coronary aneurysms and 18% of stenotic lesions could be found by 2-D Echo. No stenotic lesion could be found in distal segments of the coronary artery. CONCLUSIONS: Long term follow up revealed spontaneous regression occurred in 55% of patients and development into severe coronary artery stenosis in 7%. It is necessary to perform long-term follow-up in patients with coronary artery lesions caused by Kawasaki disease. 2-D Echo can not completely replace CAG during follow-up of coronary artery lesions caused by Kawasaki disease.

关键词： Adolescent Child Child, Preschool Coronary Aneurysm Coronary Angiography Coronary Vessels Disease Progression Female Follow-Up Studies Humans Infant Male mucocutaneous lymph node syndrome Retrospective Studies Time Factors

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Comprehensive Metabolomic Characterization in Coronary Artery Lesions of Kawasaki Disease

Comprehensive Metabolomic Characterization in Coronary Arter...

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2018年浙江省医学会儿科学分会学术年会

作者： Xuliang Wang Ping Li Yaoyao Yan Youyang Shi yi Zhan Rongzhou Wu jingzhou Chen Children's Heart Center The Second Affiliated Hospital and Yuying Children's HospitalInstitute of Cardiovascular Development and Translational MedicineWenzhou Medical University State Key Laboratory of Cardiovascular Disease FuWai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College & Chinese Academy of Medical Sciences

Background:Coronary artery lesion(CAL) was a serious complication of Kawasaki Disease(KD) which will result in stenosis and *** uncleared pathogenesis and lacking of the effective diagnostic biomarks according to CAL of KD was necessary for clinical *** and diagnostic biomarks could be discovered by metabolomic profiling of ***:40 of CAL and 39 of non-coronary artery lesion(NCAL) patients of KD after drug treatment enrolled and the plasma were collected for metabolomic *** metabolites were detected by ultra high performance liquid tandem chromatography quadrupole time of flight mass spectrometry and analyzed by multivariate statistics between ***:The metabolic profiles could clearly distinguish CAL and NCAL patients of KD at acture *** bile acid biosynthesis,phenylalanine metabolism and fatty acid biosynthesis were disorded in coronary artery *** 14 significantly different expressed metabolites were found,and palmitic acid had the biggest fold chang at 9.879 among them.A panel of 4 metabolites,1-stearoyl-sn-glycerol,palmitic acid,heptadecanoic acid and phenylethylamine had a well power to diagnosis CAL in KD patients accroding to ROC curve,the areas under the curve,sensitivity,and specificity at 0.978,95%,100%.Concluions:Plasma metabolomics had a powerful ability to discover biomarks and potential pathogenesis in KD.A panel of 4 metabolites could be biomarks to identify CAL in KD *** palmitic acid could be a new insight in furture research of KD with CAL.

关键词： Kawasaki disease mucocutaneous lymph node syndrome Coronary disease Metabolomics

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