背景:有人提出,川崎病(KD)后过敏性疾病可能会增加。我们旨在分析KD后过敏性疾病发病率的时间模式。
方法:使用来自韩国国民健康保险索赔数据库的数据,进行了一项全国性的基于人群的配对队列研究。纳入年龄<5岁的诊断为KD的患者及其1:3倾向评分匹配的对照。建立了三个队列:队列A,过敏患者;队列B,没有过敏的患者;和队列C,没有过敏的患者,但不包括有出生史和基本医疗条件的患者。过敏性鼻炎的累积发病率(%)和相关的住院次数,特应性皮炎,荨麻疹,在6年随访期间,对病例和对照组之间的哮喘进行了比较.
结果:研究人群包括8678名诊断为KD的患者和26,034名对照。在队列A中,虽然最初,某些过敏性疾病的住院次数存在组间差异,这些差异不一致,且因过敏性疾病的类型而异.随着时间的推移,分歧缩小,到第六年,差距明显缩小。在队列B和C中,与对照组相比,KD患者4种过敏性疾病的初始发病率和相关住院次数均较低.然而,以更快的速度增长,发病率和住院次数最终超过对照组.
结论:KD后过敏性疾病的累积发病率和住院次数延迟增加的模式表明,KD和过敏性疾病之间可能存在共同的遗传或免疫易感性。随着时间的推移变得很明显,而不是KD导致过敏性疾病的直接影响。
BACKGROUND: It has been suggested that allergic diseases may increase after Kawasaki disease (KD). We aimed to analyze the temporal patterns of allergic disease incidence after KD.
METHODS: A nationwide population-based matched cohort
study was conducted using data from the Korean National Health Insurance claims database. Patients aged <5 years diagnosed with KD and their 1:3 propensity score-matched controls were included. Three cohorts were established: Cohort A, patients with allergies; Cohort B, patients without allergies; and Cohort C, patients without allergies, but excluding patients with birth history and underlying medical conditions. Cumulative incidence rates (%) and associated hospital visits for allergic rhinitis, atopic dermatitis, urticaria, and asthma were compared between the cases and controls during the 6-year follow-up period.
RESULTS: The
study population comprised 8678 patients diagnosed with KD and 26,034 controls. In Cohort A, although initially, there were intergroup differences in the number of hospital visits for certain allergic diseases, these differences were inconsistent and varied depending on the type of allergic disease. Over time, the differences narrowed, and by the sixth year, the gap had decreased significantly. In Cohorts B and C, the initial incidence rates of the four allergic diseases and associated hospital visits were lower in patients with KD as compared to controls. However, with a faster rate of increase, the incidence rates and number of hospital visits eventually surpassed those of the controls.
CONCLUSIONS: The pattern of delayed increase in cumulative incidence rates and hospital visits for allergic diseases after KD suggests the possibility of a shared genetic or immunologic susceptibility between KD and allergic diseases, which becomes evident over time, rather than a direct influence of KD resulting in allergic diseases.