摘要
静脉注射免疫球蛋白(intravenous immunoglobulin,IVIG)是国际公认的川崎病(Kawasaki disease,KD)急性期主要治疗手段,其应用可有效降低冠状动脉病变(coronary artery lesions,CAL)发生率。但在临床中,有高达26.8%的KD患儿对IVIG治疗无反应,且其发生CAL的风险更高,程度更重。对于具有IVIG无反应高风险的急性KD患者,及早调整治疗方案,如早期联合应用糖皮质激素等治疗,可能对改善预后、缩短病程起到重要作用。因此,早期识别IVIG无反应型KD对临床医生具有重要意义。近20年来,国内外学者相继建立预测评分系统,以预估KD患儿IVIG无反应发生的可能性,优化早期治疗方案。该文对IVIG无反应型KD预测评分系统的国内外研究进行综述,以期为临床诊治提供参考。
Intravenous immunoglobulin(IVIG)is internationally recognized as the main treatment for Kawasaki disease(KD)in the acute phase,and its application can effectively reduce the incidence of coronary artery disease(CAL).However,in clinical practice,up to 26.8%of KD children do not respond to IVIG treatment,and their risk of CAL is higher and the degree of CAL is more severe.Early adjustment of treatment,such as early combined use of glucocorticoids,may play an important role in improving the prognosis and shortening the course of IVIG non-responsive KD.Therefore,early identification of IVIG non-response KD is of great significance to clinicians.In the past 20 years,domestic and foreign scholars have successively established predictive scoring system to predict the possibility of IVIG non-response in children with KD and optimize the early treatment.This article reviews the domestic and foreign research on the score system for predicting IVIG non-response in KD,in order to provide reference for clinical diagnosis and treatment.
作者
黄沂徐(综述)
皮光环(审校)
Huang Yixu;Pi Guanghuan(Department of Pediatrics,Women′s and Children′s Hospital Affiliated to Chengdu Medical College,Chengdu 610045,China)
出处
《国际儿科学杂志》
2023年第2期77-80,共4页
International Journal of Pediatrics
