青少年川崎病：年龄特异性临床特征和与预后相关的因素
Kawasaki disease in adolescents: age-specific clinical features and factors associated with outcomes.
摘要(中文译文)
在青少年中，川崎病（KD）通常表现为非特异性临床症状，这会延误诊断和治疗，从而增加冠状动脉病变（CAL）的风险。本研究调查了不同年龄组KD的临床特征，重点关注青少年，并确定了与治疗耐药性和CAL相关的年龄特异性因素。使用2009年至2017年韩国汇编的全国调查数据进行了回顾性分析。在诊断时，共有34408名KD患者被分为四个年龄组： < 1一年（7425；21.6%），1-4年（22629；65.8%），5-9年（4089；11.9%），以及 ≥ 10年（265；0.8%）。与较年轻的年龄组相比 ≥ 10-该年龄组的男性比例更高，总发热时间和入院前发热时间更长，不完全川崎病的可能性更大，典型症状更少，颈部淋巴结病更多，卡介苗接种部位红斑更少。尽管一些差异没有统计学意义，但该组对第一和第二次静脉注射免疫球蛋白（IVIG）治疗和二线类固醇使用的无反应率较高，冠状动脉扩张和动脉瘤较多，但冠状动脉狭窄、闭塞或死亡率没有差异。在青少年中，IVIG无反应仅与长期发热有关，CAL与复发性KD、长期发热、总蛋白水平较低和急性期肢体变化较少有关。患有KD的青少年表现出明显的临床特征、特定年龄的特征性危险因素和较高的CAL风险，这突显出需要针对特定年龄的管理策略。关键点•青少年川崎病很少见，约占所有病例的0.8%。•患有KD的青少年表现出更长的发热持续时间、更不完整的KD表现、更高的IVIG无反应率和更高的CAL发病率。•青少年KD患者的长期发热和复发性KD与治疗耐药性和CAL有关。
Abstract
In adolescents, Kawasaki disease (KD) often manifests with non-specific clinical symptoms, which delays diagnosis and treatment and consequently increases the risk of coronary artery lesions (CALs). This study investigated the clinical characteristics of KD across age groups, focusing on adolescents, and identified age-specific factors associated with treatment resistance and CALs. A retrospective analysis was conducted using nationwide survey data compiled in South Korea from 2009 to 2017. A total of 34,408 patients with KD were stratified into four age groups at the time of diagnosis: < 1 year (7425; 21.6%), 1-4 years (22,629; 65.8%), 5-9 years (4089; 11.9%), and ≥ 10 years (265; 0.8%). Compared to younger age groups, the ≥ 10-year age group had a greater proportion of males, longer total and pre-admission fever duration, a greater likelihood of incomplete KD with fewer typical symptoms, more cervical lymphadenopathy, and less erythema at the Bacillus Calmette-Guérin inoculation site. Although some differences were not statistically significant, this group had higher rates of unresponsiveness to first and second intravenous immunoglobulin (IVIG) treatments and second-line steroid use, and more coronary dilatation and aneurysms, but no differences in coronary stenosis, occlusion, or mortality. In adolescents, IVIG unresponsiveness was only associated with prolonged fever, and CALs was associated with recurrent KD, prolonged fever, lower total protein levels, and fewer acute-phase extremity changes. Adolescents with KD exhibit distinct clinical features, characteristic age-specific risk factors, and a higher risk of CALs, highlighting the need for age-specific management strategies. Key Points • KD in adolescence is rare, accounting for approximately 0.8% of all cases. • Adolescents with KD exhibited longer fever duration, more incomplete KD presentation, higher rates of unresponsiveness to IVIG, and a greater incidence of CALs. • Prolonged fever and recurrent KD were associated with treatment resistance and CALs in adolescent KD.
如何引用
AMA
Hee Joung Choi, So Hyeon Gwon, Nak-Hoon Son, Gi Beom Kim. Kawasaki disease in adolescents: age-specific clinical features and factors associated with outcomes.. Clinical rheumatology. 2026; doi:10.1007/s10067-025-07770-9.
APA
Hee Joung Choi, So Hyeon Gwon, Nak-Hoon Son, Gi Beom Kim (2026). Kawasaki disease in adolescents: age-specific clinical features and factors associated with outcomes.. Clinical rheumatology. https://doi.org/10.1007/s10067-025-07770-9
GB/T 7714
Hee Joung Choi, So Hyeon Gwon, Nak-Hoon Son, Gi Beom Kim. Kawasaki disease in adolescents: age-specific clinical features and factors associated with outcomes.[J]. Clinical rheumatology, 2026 doi:10.1007/s10067-025-07770-9.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出