摘要
川崎病好发于5岁以下儿童,发病率逐年上升,其病因和发病机制尚未完全明确,主要并发症为冠状动脉损伤,是儿童后天获得性心脏病最主要的病因。糖皮质激素(GC)最初被禁用于川崎病患儿,认为其可增加冠状动脉病变风险。随着静脉注射免疫球蛋白(IVIG)无反应发生率的升高,GC被作为免疫球蛋白治疗无反应患儿的补救措施。近年来,GC治疗川崎病已成为研究的热点,GC可作为预测IVIG无反应和冠状动脉病变高风险患儿的初始治疗。随着对GC治疗川崎病的进一步研究,GC的应用或可降低IVIG剂量,甚至可能成为IVIG的替代治疗。
Kawasaki disease tends to occur in children under 5 years old,and its incidence is increasing year by year.The etiology and pathogenesis of Kawasaki disease have not been fully clarified.Its main complication is coronary artery injury,which is the most important cause of acquired heart disease in children.The use of glucocorticoids(GC)in the treatment of Kawasaki disease has long been controversial.Initially,GC was banned in children with Kawasaki disease because it′s thought that it could increase the risk of coronary artery disease.With the increasing incidence of no reaction to intravenous immunoglobulin(IVIG),GC as the remedial measure to gamma globulin,has become a research hot spot in the field in recent years.GC can be used as the initial treatment for children with predicted no response to intravenous gamma globulin and children with high risk of coronary artery disease.With the further study on the treatment of Kawasaki disease by GC,the application of GC may reduce the dose of IVIG and even become an alternative treatment for IVIG.
作者
李芳芳
李崇巍
LI Fangfang;LI Chongwei(Department of Rheumatology and Immunology,Tianjin Children′s Hospital,Tianjin 300134,China)
出处
《医学综述》
2020年第12期2396-2401,共6页
Medical Recapitulate
关键词
川崎病
糖皮质激素
静脉注射免疫球蛋白无反应
冠状动脉
Kawasaki disease
Glucocorticoid
Non-response to intravenous immunoglobulin
Coronary artery
