川崎病的流行病学和临床特征及心脏受累的危险因素：一项关于32名突尼斯儿童的研究

IF 2.2 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2025-09-01 DOI:10.1016/j.acvd.2025.06.036

Rania Gargouri , Ines Maaloul , Imen Chabchoub , Hajer Aloulou , Salma Charfeddine , Leila Abid

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引用次数: 0

摘要

儿童动脉。未经治疗，约25%的患者出现冠状动脉并发症，使KD成为5岁以下儿童中最常见的血管炎。虽然其发病率在日本最高，但突尼斯的数据仍然有限。早期诊断和静脉注射免疫球蛋白（IVIG）治疗可显著降低冠状动脉病变（CAL）的风险。方法本研究旨在分析突尼斯KD患儿心血管受累的临床和超声心动图特征，并确定与心脏并发症相关的危险因素。方法2015年1月至2021年12月在突尼斯斯法克斯hsamdi Chaker大学医院进行回顾性、描述性和分析性研究。根据美国心脏协会（AHA）的标准，14岁以下的儿童被诊断为完全或不完全形式的KD。收集临床、生物学和超声心动图资料。结果32例患者（女孩18例，男孩14例，平均年龄3.6±2.6岁）中，65.6%为不完全性KD。78%的病例（n = 25）出现心脏受累，包括冠状动脉扩张（n = 23）、冠状动脉高回声（n = 15）和动脉瘤（n = 4）。左冠状动脉更常见（n = 19）。c反应蛋白升高（CRP≥50 mg/L, p = 0.002）和白细胞增多（≥15,000/mm3, p = 0.04）是多因素分析中CAL的独立预测因子。所有患者均接受IVIG （2g /kg）和乙酰水杨酸治疗，结果良好。结论不完全型KD在突尼斯队列中占主导地位，CAL患病率高。CRP升高和白细胞增多是心脏受累的重要危险因素。早期识别这些预测因素可以改善风险分层，并指导及时干预以预防冠状动脉并发症。

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Epidemiological and clinical features of Kawasaki disease and risk factors for cardiac involvement: A study about 32 Tunisian children

Introduction

Arteries in children. Untreated, approximately 25% of patients develop coronary complications, making KD the most common vasculitis in children under 5 years of age. While its incidence is highest in Japan, data from Tunisia remain limited. Early diagnosis and treatment with intravenous immunoglobulins (IVIG) significantly reduce the risk of coronary artery lesions (CAL).

Method

This study aimed to analyze the clinical and echocardiographic features of cardiovascular involvement in a cohort of Tunisian children with KD and identify risk factors associated with cardiac complications.

Methods

A retrospective, descriptive, and analytical study was conducted at Hédi Chaker University Hospital in Sfax, Tunisia, from January 2015 to December 2021. Children under 14 years diagnosed with complete or incomplete form of KD according to the American Heart Association (AHA) criteria were included. Data on clinical, biological, and echocardiographic features were collected. Statistical analysis was performed using IBM SPSS version 20, with multivariate logistic regression to identify risk factors for CAL.

Results

Among 32 patients (18 girls, 14 boys; mean age 3.6 ± 2.6 years), 65.6% had incomplete KD. Cardiac involvement was observed in 78% of cases (n = 25), including coronary artery dilation (n = 23), hyperechogenicity of coronary arteries (n = 15), and aneurysms (n = 4). The left coronary artery was more frequently affected (n = 19). Elevated C-reactive protein (CRP ≥ 50 mg/L; p = 0.002) and leukocytosis (≥ 15,000/mm³; p = 0.04) were independent predictors of CAL in multivariate analysis. All patients received IVIG (2 g/kg) and acetylsalicylic acid, with favorable outcomes.

Conclusion

Incomplete form of KD was predominant in this Tunisian cohort, with a high prevalence of CAL. Elevated CRP and leukocytosis were significant risk factors for cardiac involvement. Early identification of these predictors may improve risk stratification and guide timely intervention to prevent coronary complications.

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.