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[川崎病。三个问题:不完全临床形式、类固醇治疗、低剂量阿司匹林]

[Kawasaki's disease. 3 problems: incomplete clinical forms, steroid treatment, low doses of aspirin].

作者信息

Di Piero G, Cupini V, Isola M L, Stirpe S, Bellisario G, Garibaldi G, Proia R

出版信息

Pediatr Med Chir. 1986 Mar-Apr;8(2):233-41.

PMID:2431396
Abstract

After a brief review of the recent literature and the description of the clinical and echocardiographic follow-up of 9 cases observed from 1976 to 1985, the authors stress the relative importance to recognize patients who do not fulfill the classic criteria for the diagnosis of Kawasaki disease, in order to treat with antiaggregants those affected by coronary aneurysms. Moreover they discuss the beneficial effects of steroids, in association with salicylates, given only in the first two weeks of disease when the production and deposit of immunocomplexes and the release of lysosomal enzymes from macrophage cells occur. Finally the authors point out that the treatment with low doses of salicylates selectively acting on thromboxane A2 and not on Pgl2, as shown in experimental studies, remains to be confirmed by clinical trials.

摘要

在简要回顾近期文献并描述了1976年至1985年间观察到的9例患者的临床及超声心动图随访情况后,作者强调识别那些不符合川崎病经典诊断标准的患者的相对重要性,以便对患有冠状动脉瘤的患者使用抗血小板药物进行治疗。此外,他们讨论了类固醇与水杨酸盐联合使用的有益效果,这种联合用药仅在疾病的前两周使用,此时免疫复合物的产生和沉积以及巨噬细胞溶酶体酶的释放会发生。最后,作者指出,如实验研究所示,低剂量水杨酸盐选择性作用于血栓素A2而非前列环素的治疗方法仍有待临床试验证实。

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