30年来以人群为基础的川崎病感染负担的相关性

IF 5.1 2区 医学 Q1 RHEUMATOLOGY RMD Open Pub Date : 2025-01-20 DOI:10.1136/rmdopen-2024-005160
Johannes Mofors, André Rudolph, Bodil Schiller, Göran Elinder, Sven-Erik Sonesson, Håkan Eliasson, Gunnar Bergman, Marie Wahren-Herlenius
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摘要

目的:本研究旨在探讨感染在川崎病发病机制中的作用。方法:采用全国流行病学病例对照研究,纳入1987-2018年在瑞典确诊的所有川崎病病例。对照从一般人群中随机抽样,按性别、年龄和居住地区进行匹配。感染数据来自瑞典国家患者登记册,该登记册前瞻性地收集了所有瑞典居民的数据。根据器官系统、感染源及与川崎病诊断日期的时间接近程度对感染进行分类。抗生素处方和家庭成员感染也在单独的分析中考虑。结果:本研究纳入n=1774例(61%为男性)和n= 17731例对照。总体而言,感染史与川崎病相关的OR为2.3 (95% CI 2.0 - 2.5)。呼吸道、皮肤、泌尿生殖系统和胃肠道感染都与川崎病有关。时间分层显示,在川崎病诊断前几周感染聚集性突出,但在川崎病前几个月感染的频率也较高,OR范围为川崎病前15-28天5.1 (95% CI 3.6 - 7.1)至181-365天1.3 (95% CI 1.1 - 1.6)。观察到剂量-反应关系,反复感染与川崎的高ORs相关。结论:研究结果表明,感染与川崎病密切相关,并且与以前已知的更广泛的时间关联。此外,数据表明许多不同的因素可能诱发这种疾病。
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Associations of infection burden with Kawasaki disease in a population-based setting during 30 years.

Objectives: The objective of this study was to investigate the role of infections in the pathogenesis of Kawasaki disease.

Methods: The investigation was a nationwide epidemiological case-control study, comprising all cases of Kawasaki disease diagnosed in Sweden 1987-2018. Controls were randomly sampled from the general population, matched on sex, age, and area of residency. Data on infections were obtained from the Swedish National Patient Register, which prospectively collects data on all Swedish residents. Infections were classified by organ system, infectious agent and by temporal proximity to Kawasaki disease diagnosis date. Prescription of antibiotics and infections in family members were also considered in separate analyses.

Results: The study comprised n=1774 (61% male) cases and n=17 731 controls. Overall, a history of infections was associated with Kawasaki disease with an OR of 2.3 (95% CI 2.0 to 2.5). Respiratory, skin, urogenital and gastrointestinal tract infections were all associated with Kawasaki disease. Temporal stratification revealed a prominent clustering of infections during the weeks before a Kawasaki diagnosis, but also higher frequencies of infections several months preceding Kawasaki disease with OR ranging from 5.1 (95% CI 3.6 to 7.1) 15-28 days to 1.3 (95% CI 1.1 to 1.6) 181-365 days prior Kawasaki disease. A dose-response relationship was observed, with repeated infections associating with higher ORs of Kawasaki.

Conclusions: The findings suggest that infections are closely linked with Kawasaki disease, and with a wider temporal association than previously known. Further, the data imply that many different agents may induce the disease.

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来源期刊
RMD Open
RMD Open RHEUMATOLOGY-
CiteScore
7.30
自引率
6.50%
发文量
205
审稿时长
14 weeks
期刊介绍: RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
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