摘要
川崎病是累及包括小型和中型口径血管的系统性血管炎,亦被称为皮肤黏膜淋巴结综合征。是一种急性儿童血管性疾病,心血管损害是川崎病最严重的并发症。川崎病的病因仍不明确,很难用一个学说阐述清楚其发病机制。川崎病的诊断目前为止依然是排除性临床诊断,应用冠状动脉内径Z值对川崎病诊断、管理及评估预后具有重要意义,临床上对不完全川崎病的早期识别很重要。早期大剂量静脉注射免疫球蛋白(IVIG)联合阿司匹林治疗可以有效地抑制免疫炎症反应,但部分患儿表现为IVIG抵抗。随着对川崎病深入研究一些新的治疗方案不断出现,包括肿瘤坏死因子拮抗剂、甲氨蝶呤、氯吡格雷、双嘧达莫、利妥昔单抗、血浆置换等以及结合中医中药治疗。本文将儿童川崎病诊治进展进行总结。
Kawasaki disease is a systemic vasculitis involving small and medium-sized blood vessels,also known as mucocutaneous lymph node syndrome.Kawasaki disease is an acute vascular disease in children.Cardiovascular damage is the most serious complication of Kawasaki disease.The etiology of Kawasaki Disease is still unclear,and the pathogenesis is difficult to explain with a theory.So far,the diagnosis of KD is still an excluded clinical diagnosis.The application of Z value of coronary artery diameter is very important for the diagnosis,management and prognosis assessment of KD.Early high-dose intravenous immunoglobulin(IVIG)combined with aspirin therapy can effectively inhibit the immune inflammatory response,but some children present with IVIG resistance.As Kawasaki disease continues to be studied,new treatments are emerging,including TNF antagonists,methotrexate,clopidogrel,dipyridamole,rituximab,plasmapheresis,and combination of traditional Chinese medicine.This article summarizes the progress in diagnosis and treatment of Kawasaki disease in children.
作者
陈强
訾慧芬
侯毅
杨雯
赵海燕
马莹莹
CHEN Qiang;ZI Huifen;HOU Yi;YANG Wen;ZHAO Haiyan;MA Yingying(Central Hospital of Baotou City, Baotou 014040,China)
出处
《中国中西医结合儿科学》
2020年第5期387-391,共5页
Chinese Pediatrics of Integrated Traditional and Western Medicine
基金
包头市科技计划项目(2019Z3009-7)。
关键词
川崎病
诊治
儿童
Kawasaki disease
Diagnosis and treatment
Children
