探讨儿童再发川崎病的发生率、临床特征及冠状动脉病变(CAL)发生情况。

选择2010年5月至2019年10月，青岛市妇女儿童医院心脏中心收治的10例再发川崎病患儿为研究对象。回顾性分析这10例患儿的临床病例资料。采用配对t检验、Fisher确切概率法及Wilcoxon符号秩和检验，对10例患儿初发与再发时的临床表现、实验室检查结果等进行统计学比较。对国内外儿童再发川崎病相关文献进行文献复习。本研究经青岛市妇女儿童医院伦理委员会批准(审批文号：QFELL-KY-2019-64)。

①本中心2010年1月至2019年12月，川崎病再发率为1.16%(10/865)，再发川崎病患儿中，男性患儿为7例、女性为3例。②10例患儿川崎病再发时年龄为(42.0±15.8)个月，初发至再发间隔时间为(12.1±6.2)个月，出院后随访至2020年4月预后良好。③本组川崎病患儿初发与再发时热程，皮疹、淋巴结肿大、球结膜充血、口唇充血及手足硬肿发生率，血清C反应蛋白(CRP)、红细胞沉降率(ESR)、血红蛋白(Hb)、白蛋白、丙氨酸转氨酶(ALT)及天冬氨酸氨基转移酶(AST)水平，以及白细胞及血小板计数比较，差异均无统计学意义(均为P>0.05)。初发与再发时，其CAL发生率比较，差异亦无统计学意义(P>0.05)。④文献复习结果：川崎病再发率为1.3%～3.4%，男性患儿多见，初发患儿年龄为0.4～2.2岁，初发距再发的间隔时间为1.0～3.3年，再发时患儿热程多短于初发时；川崎病患儿初发与再发时CAL发生率分别为6.3%～45.5%、6.3%～60.0%。

再发川崎病多见于5岁以下儿童，并且多发生于初次发病后1.5年内，再发患儿的CAL发生率较初发患儿无明显升高。尚未发现与川崎病再发明确相关的危险因素，婴幼儿期初发川崎病患儿其再发可能性更高。

To explore the incidence, clinical features and coronary artery lesion (CAL) of recurrent Kawasaki disease.

From May 2010 to October 2019, a total of 10 children with recurrent Kawasaki disease who admitted to the Heart Center of Qingdao Women and Children′s Hospital were selected as research subjects. Their clinical data were analyzed retrospectively, and comparison with whose initial Kawasaki disease of clinical manifestations and laboratory examination results were conducted by paired t-test, Fisher′s exact probability method and Wilcoxon signed rank sum test. The literatures about children with recurrent Kawasaki disease at home and abroad were reviewed. This study was approved by the Ethics Committee of Qingdao Women and Children′s Hospital (Approval No. QFELL-KY-2019-64).

①From January 2010 to December 2019, the recurrence rate of Kawasaki disease was 1.16% (10/865), among of recurrent Kawasaki disease children, there were 7 males and 3 females. ②The age of 10 children with recurrent Kawasaki disease was (42.0±15.8) months at the time of recurrence, and the interval between the initial onset and recurrence was (12.1±6.2) months. They were followed up from discarge to April 2020, and the prognosis was good. ③Comparison of related indicators: there were no significant differences between 10 children with recurrent Kawasaki disease at the time of initial onset and recurrence in duration of fever, incidence of rash, lymphadenectasis, bulbar conjunctiva hyperremia, lip congestion and scleroma of hands and feet, serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), albumin, alanine transaminase (ALT) and aspartate aminotransferase (AST), and white blood cell count and platelet count (all P>0.05). Also incidence of CAL (P>0.05). ④Results of literature review: recurrence rate of Kawasaki disease was 1.3%-3.4%, male children were more common, the age of initial onset was 0.4-2.2 years, interval from initial onset to recurrence was 1.0-3.3 years, fever duration of recurrence was shorter than that of initial onset, incidence of CAL of children with Kawasaki disease at the time of initiate and recurrent were 6.3%-45.5% and 6.3%-60.0%, respectively.

Recurrent Kawasaki disease was more common in children under 5 years old, and most of them occurred within 1.5 years after initial onset. The incidence of CAL of children with recurrent Kawasaki disease did not increase significantly compared to their initial onset. No clear risk factors related to recurrence of Kawasaki disease have been found yet. Children with Kawasaki disease in infancy may have a higher risk of recurrence.