Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
1
admin
1735-9260
1735-9279
fa
jalali
1401
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1
gregorian
2022
9
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32
212
online
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fulltext
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بررسی خصوصیات اپیدمیولوژیک و بالینی بیماری کاوازاکی در مازندران
Epidemiological and Clinical Characteristics of Kawasaki Disease in Mazandaran
اپیدمیولوژی
Epidemiology
پژوهشي-کامل
Research(Original)
<span style="font-size:12pt"><span style="line-height:87%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:87%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:87%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA" style="font-family:"B Zar"">کاوازاکی یک واسکولیت حاد دوران کودکی با علت ناشناخته است که </span><span lang="AR-SA" style="font-family:"B Zar"">درصورت عدم درمان، در <span style="letter-spacing:-.1pt">25 درصد موارد می</span></span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar""><span style="letter-spacing:-.1pt">تواند منجر به آنوریسم کرونر شود.</span></span><span lang="AR-SA" style="font-family:"B Zar""><span style="letter-spacing:-.1pt"> این بیماری علت اصلی بیماری قلبی اکتسابی در کودکان کشورهای</span></span><span lang="AR-SA" style="font-family:"B Zar""> توسعه یافته است. هدف از انجام این مطالعه </span><span lang="AR-SA" style="font-family:"B Zar"">بررسی خصوصیات اپیدمیولوژیک و بالینی بیماری</span><span lang="AR-SA" style="font-family:"B Zar""> کاوازاکی در مازندران</span><b> </b><span lang="AR-SA" style="font-family:"B Zar"">بود.</span><span lang="FA" style="line-height:87%"><span style="font-family:"B Zar""><span style="color:#0e101a"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:87%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:87%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:87%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:87%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="AR-SA" style="font-family:"B Zar"">در این مطالعه توصیفی-تحلیلی مرور پرونده، </span><span lang="AR-SA" style="font-family:"B Zar"">تمامی موارد ثبت شده </span><span lang="AR-SA" style="font-family:"B Zar"">بیماری کاوازاکی از سال 1398-1386 در استان مازندران </span><span lang="AR-SA" style="font-family:"B Zar"">مورد بررسی قرار گرفتند</span><span lang="AR-SA" style="font-family:"B Zar"">. اطلاعات اپیدمیولوژیک،</span> <span lang="AR-SA" style="font-family:"B Zar"">دموگرافیک، بالینی، آزمایشات دوره</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">ای، ریسک فاکتورها، بار بیماری، عوارض و پیگیری بیماران توسط نرم</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">افزار جمع</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">آوری شدند. تجزیه و تحلیل داده</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">ها با آمار توصیفی و آزمون کای دو و رگرسیون لجستیک انجام شد.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:87%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:87%"><span style="font-family:"B Koodak""><span style="color:black">یافته</span></span></span><span lang="FA" style="line-height:87%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:87%"><span style="font-family:"B Koodak""><span style="color:black">ها:</span></span></span> <span lang="AR-SA" style="font-family:"B Zar"">اطلاعات 136 کودک مورد بررسی قرار گرفت. </span><span lang="AR-SA" style="font-family:"B Zar"">کودکان مبتلا به کاوازاکی کامل و ناکامل از نظر علائم بالینی تفاوت معنی</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">داری داشتند(</span><span lang="AR-SA" style="font-family:"B Zar"">0/001</span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:87%"><span style="font-family:"B Zar"">></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">P</span></span><span lang="AR-SA" style="font-family:"B Zar"">). اغلب کودکان مبتلا به کاوازاکی کامل و ناکامل به ترتیب 63/2 درصد و 75/5 درصد درگیری قلبی و 52/6 درصد و 58/2درصد درگیری عروق کرونر داشتند اما تفاوت معنی</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">داری بین دو گروه از نظر درگیری قلبی و عروق کرونر یافت نشد(0/05</span><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:87%"><span style="font-family:"B Zar""><</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">P</span></span><span lang="AR-SA" style="font-family:"B Zar"">). نتایج رگرسیون چند متغیره نشان داد مدت زمان تب بیش</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">تر از 5 روز به عنوان </span></span></span></span></span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span style="font-family:"B Zar"">یک پیش</span></span><span dir="RTL" lang="AR-BH" style="font-size:12.0pt"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span style="font-family:"B Zar"">بینی</span></span><span dir="RTL" lang="AR-BH" style="font-size:12.0pt"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:12.0pt"><span style="font-family:"B Zar"">کننده </span></span><span style="font-size:12pt"><span style="line-height:87%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="font-family:"B Zar""> </span><span lang="AR-SA" style="font-family:"B Zar""> درگیری عروق کرونر مطرح می</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">شود(</span><span lang="FA" style="font-family:"B Zar"">0/001=</span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">P</span></span><span lang="FA" style="font-family:"B Zar"">).</span><span lang="FA" style="line-height:87%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:87%"><span style="tab-stops:right 468.0pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:87%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="AR-SA" style="font-family:"B Zar"">نتایج نشان داد تب بیش</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">تر از 5 روز به عنوان ریسک فاکتور درگیری قلبی و عروق کرونر به عنوان یکی از عوارض منجر به مرگ این بیماری در کودکان گزارش شده است. لذا کنترل دقیق تب و بررسی</span><span lang="AR-BH" style="line-height:87%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="AR-SA" style="font-family:"B Zar"">های قلبی در کودکان با علائم بیماری کاوزاکی اهمیت دارد. </span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%"></span></span></span></span></span></span></span></span><br>
<br>
<span style="font-size:12pt"><span style="line-height:115%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif"">Background and purpose<span style="letter-spacing:-.2pt">:</span></span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">Kawasaki is an acute childhood vasculitis of unknown cause that if left untreated can cause coronary aneurysms in 25% of cases.</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">The disease is reported as the leading cause of acquired heart disease in children in developed countries.</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">The purpose of this study was to investigate the epidemiological and clinical features of Kawasaki disease in northern Iran.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:115%"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif"">Materials and methods:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">In this descriptive-analytic review study, all registered cases of Kawasaki disease in Mazandaran province between 2007 and 2019 were investigated.</span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%"> Epidemiological, demographic, clinical, periodical tests, risk factors, disease burden, complications, and follow-up information were collected. Data analysis was done applying descriptive statistics, Chi-square test, and logistic regression.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"Arial","sans-serif"">Results:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">The data of 136 children with Kawasaki disease were assessed. Clinical symptoms were found to be significantly different between children with complete and incomplete Kawasaki disease (P<0.001). Most children with complete and incomplete Kawasaki disease had heart disease (63.2% and 75.5%, respectively), and coronary artery disease (52.6% and 58.2%, respectively) but no significant differences were found between the two groups in terms of cardiovascular involvement (P>0.05).</span></span> <span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">Multivariate regression analysis showed that fever for more than 5 days is a predictor of coronary artery involvement (P= 0.001).</span></span></span></span></span></span><br>
<b><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="letter-spacing:-.2pt">Conclusion:</span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.2pt">The study showed that fever for more than 5 days is a risk factor for heart and coronary artery involvement as one of the complications leading to death in these children. Therefore, accurate</span></span></span> <span lang="EN" style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""><span style="letter-spacing:-.2pt">control of fever and heart examinations are important in children with symptoms of </span></span></span><br>
بیماری کاوازاکی, کودکان, بثورات جلدی, واسکولیت
Kawasaki disease, children, skin rash, vasculitis
97
106
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-228-7&slc_lang=fa&sid=1
Mahboube
Jafari Sarouei
محبوبه
جعفری سارویی
jafarisaroui@gmail.com
1003194753284600147563
1003194753284600147563
No
Assistant Professor, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماریهای واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Mahsa
Kamali
مهسا
کمالی
kamali2n@gmail.com
1003194753284600147564
1003194753284600147564
No
MSc in Nursing, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
کارشناسی ارشد پرستاری، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماریهای واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Fahimeh
Ghasemi Charati
فهیمه
قاسمی چراتی
Fahime.ghasemi24@gmail.com
1003194753284600147565
1003194753284600147565
No
MSc in Nursing, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
کارشناسی ارشد پرستاری، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماریهای واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Leila
Shahbaznejad
لیلا
شهبازنژاد
leilashahbaznezhad@gmail.com
1003194753284600147566
1003194753284600147566
No
Assistant Professor, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماریهای واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Azin
Hajalibeig
آذین
حاجی علی بیگ
azin2263@yahoo.com
1003194753284600147567
1003194753284600147567
No
Pediatrician, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
متخصص کودکان، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماریهای واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Kiana
Razavi-Amoli
کیانا
رضوی آملی
kianarazavi2016@gmail.com
1003194753284600147568
1003194753284600147568
No
Medical Student, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Mohammad Sadegh
Rezai
محمدصادق
رضایی
drmsrezaii@yahoo.com
1003194753284600147569
1003194753284600147569
Yes
Professor, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
استاد، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران