가와사키 환아의 장기 예후에 대한 연구
Long Term Follow-up Study of Patients with Kawasaki Disease
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목적: 국내 가와사키병 환아의 장기 예후에 대해 알아보고 장기 추적 관찰의 필요성에 대해 논의하고자하는 것이다. 방법: 가와사키병으로 입원한 354명에서 심초음파 검사와 운동부하검사에 동의한 환아 48명을 대상으로 하였다. 발병 후부터 재내원하여 추적검사를 받기까지 평균 11.6년(8.2-17.0년) 경과하였다. 발병당시 관상동맥류가 없었던 환자군을 1군, 소동맥류가 있었던 환자군을 2군으로 구분하여 장기추적검사상 두 군의 차이와 이상소견여부를 분석하였다. 결과: 장기 추적목적의 초음파와 운동부하검사에서 대부분 이상 소견을 보이지 않았으나 2군에서 9세남아 1명이 관상동맥 확장소견을 보였다. 운동부하검사는 두 군 모두 정상 소견을 보였고 심초음파 검사상 1군에서 100%, 2군에서 93.3%에서 이상이 없었다. 결론: 소동맥류가 있었던 환자군 중 일부에서 관상동맥 확장을 보였으므로 관상동맥 합병증이 발생한환자에서 선택적으로 장기적인 추적검사가 필요할 것으로 보인다.
Abstract
Purpose: To investigate the long-term prognosis of patients with Kawasaki disease in Korea, and discuss the need for long-term follow-up. Methods: The subjects were 48 patients among 354 who had been hospitalized due to Kawasaki disease, and who consented to echocardiography and exercise challenge testing. The mean duration from the onset of disease to follow-up testing after rehospitalization was 11.6 years (8.2-17.0). Patients without coronary artery aneurysms at the initial presentation of the disease were classified in group 1, and patients with small aneurysms were in group 2. Test abnormalities and differences between the two groups were analyzed. Result: There were no significant differences in the results of follow-up echocardiography and exercise challenge testing between the two groups. Although no abnormal findings were noted at follow-up in most patients, a 9-year-old boy in group 2 showed coronary artery dilation. The exercise test indicated normal results in both groups, and echocardiography results were also normal in 100% of cases in group 1 and 93.3% of cases in group 2. Conclusions: As some patients with coronary aneurysms showed coronary artery dilation, we believe that long-term follow-up may be selectively required in patients with coronary artery complications.
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