بررسی اختلالات قلبی- عروقی زودرس و دیررس در کودکان مبتلا به بیماری کاوازاکی و عوامل خطر مرتبط با آن‌ها

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استاد، گروه کودکان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استادیار، گروه کودکان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشجوی پزشکی، دانشکده‌ی پزشکی و کمیته‌ی پژوهش‌های دانشجویان، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: بیماری کاوازاکی، یک واسکولیت حاد و خود محدود شونده با اتیولوژی نامشخص است. اختلالات قلبی- عروقی، شایع‌ترین عارضه‌ی جدی بیماری کاوازاکی است. هدف از انجام این مطالعه، بررسی اختلالات قلبی- عروقی زودرس و دیررس در کودکان مبتلا به کاوازاکی و عوامل خطر مرتبط با آن‌ها می‌باشد.روش‌ها: این مطالعه‌ی هم‌گروهی گذشته‌نگر، بر روی 85 بیمار مبتلا به کاوازاکی انجام شد. تمامی بیماران تحت اکوکاردیوگرافی قرار گرفتند و همچنین، پرونده‌های بیماران بررسی شد. بیماران به گروه‌های دارای اختلالات قلبی- عروقی زودرس و دیررس و فاقد این اختلالات تقسیم شدند و بر روی داده‌ها آنالیز آماری صورت گرفت.یافته‌ها: شایع‌ترین اختلال قلبی- عروقی زودرس و دیررس به ترتیب، نارسایی میترال (9/45 درصد) و نارسایی تریکوسپید (0/20 درصد) بود. در آنالیز Logistic regression، دریافت دز دوم ایمنوگلوبولین داخل وریدی (IVIG یا Intravenous immunoglobulin) با نسبت شانس 81/2 به عنوان عوامل خطر اختلال قلبی- عروقی زودرس مشخص گردید. همچنین، افراد مبتلا به اختلال قلبی- عروقی در شروع بیماری، شانس بیشتری برای ابتلا به اختلالات قلبی- عروقی دیررس داشتند (نسبت شانس = 23/7 و حدود اطمینان = 8/26-95/1).نتیجه‌گیری: در این مطالعه مشخص گردید که افراد دریافت کننده‌ی دز دوم IVIG در معرض خطر بیشتری برای ابتلا به اختلالات قلبی- عروقی زودرس هستند. ابتلا به اختلالات قلبی- عروقی در مرحله‌ی ابتدایی بیماری، به عنوان عامل خطر اختلالات قلبی- عروقی دیررس مطرح گردید. برای ارزیابی بهتر، مطالعاتی با حجم نمونه‌ی بیشتر و آینده‌نگر پیشنهاد می‌گردد.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of Early- and Late-onset Cardiovascular Disorders and Related Risk Factors in Children with Kawasaki Disease

نویسندگان [English]

  • Mohammad Reza Sabri 1
  • Hamid Rahimi 2
  • Seyed Mojtaba Mousavi 3
  • Amin Abedini 3
  • Peyman Roomizadeh 3
  • Farhad Mahmoudi 3
  • Ebrahim Haghighizadeh 3
1 Professor, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Student of Medicine, School of Medicine AND Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Kawasaki disease is an acute and self-limited vasculitis which has unknown etiology. Cardiovascular disorders (CVDs) are the most common serious complication of this disease. The main aim of this study was the evaluation of early- and late-onset cardiovascular disorders and related risk factors in children with Kawasaki disease.Methods: This historical cohort study was conducted among 85 patients with Kawasaki disease. Echocardiography was performed in all the patients. Besides, medical documents of all the patients were evaluated. Patients were divided in groups with and without early- and late-onset cardiovascular disorders and then, statistical analysis was performed on data.Findings: The most common early- and late-onset cardiovascular disorders were mitral regurgitation (45.9%) and tricuspid regurgitation (20%), respectively. In logistic regression analysis, patients which received second dose of intravenous immunoglobulin (IVIG) showed significantly higher risk of early-onset cardiovascular disorders (OR: 2.81, 95%CI: 1.05-7.51). In addition, patients who had cardiovascular disorders in onset of the disease showed higher risk for late-onset cardiovascular disorders (OR: 7.23, 95%CI: 1.95-26.8).Conclusion: In this study, it was shown that patients who received second dose of IVIG were on higher risk for early onset cardiovascular disorders. Suffering of cardiovascular disorders in initial phase of the disease was proposed as risk factor for late onset these disorders. For better evaluation, studies with larger sample size and prospective design are suggested.

کلیدواژه‌ها [English]

  • Kawasaki disease
  • Cardiovascular disorders
  • Children

مراجع

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مجله دانشکده پزشکی اصفهان
دوره 34، شماره 396 - شماره پیاپی 396
مهر و آبان 1395
صفحه 998-1006

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سابقه مقاله

  • تاریخ دریافت: 01 خرداد 1395
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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