Bachlava Evangelia, Loukopoulou Sophia, Karanasios Evangelos, Chrousos George, Michos Athanasios
First Department of Pediatrics, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.
Department of Cardiology, "Aghia Sophia" Children's Hospital, Athens, Greece.
Int J Cardiol. 2016 Oct 1;220:65-9. doi: 10.1016/j.ijcard.2016.06.062. Epub 2016 Jun 20.
There are limited data regarding the possible benefits of abciximab in children with Kawasaki disease (KD), who developed serious cardiac abnormalities non-responsive to standard treatment.
We retrospectively identified children with KD who were treated with abciximab from 2007 to 2015. Data regarding clinical course, treatment, echocardiographic data and follow-up at 1 and 6months were retrieved.
During the study period, fifteen children were identified who were diagnosed with KD and were given abciximab. The median age at onset of symptoms was 11months (range: 2months-6years). The median day of disease at admission was 10days (range: 4-26days) and the median day of administration of abciximab was 17days (range: 9-40). Twelve children were diagnosed with complete and three with incomplete KD. Aneurysms were found in 8 children: 2 had ectatic coronary arteries and 5 presented with both ectasia and aneurysms. At 1month follow-up, echocardiographic findings showed regression in the size of aneurysms in 11 children, resolution of the aneurysms or ectasia of coronary arteries in 3 children, while one child who could not take aspirin because of G6PD deficiency died. After 6months of follow-up, echocardiographic findings showed resolution of coronary abnormalities in 12 (80%) children, whereas 2 children (13.3%) presented with significant regression of aneurysms.
Abciximab may have an important role in the management of severe cardiac complications of KD, although prospective randomized controlled studies are needed to fully evaluate its role.
关于阿昔单抗对患有川崎病（KD）且出现对标准治疗无反应的严重心脏异常的儿童可能具有的益处，相关数据有限。
我们回顾性确定了2007年至2015年期间接受阿昔单抗治疗的KD患儿。检索了有关临床病程、治疗、超声心动图数据以及1个月和6个月随访情况的数据。
在研究期间，确定了15名被诊断为KD并接受阿昔单抗治疗的儿童。症状出现时的中位年龄为11个月（范围：2个月至6岁）。入院时疾病的中位天数为10天（范围：4至26天），阿昔单抗给药的中位天数为17天（范围：9至40天）。12名儿童被诊断为完全性KD，3名被诊断为不完全性KD。8名儿童发现有动脉瘤：2例有冠状动脉扩张，5例既有扩张又有动脉瘤。在1个月随访时，超声心动图结果显示11名儿童的动脉瘤大小缩小，3名儿童的动脉瘤或冠状动脉扩张消失，而1名因葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症不能服用阿司匹林的儿童死亡。随访6个月后，超声心动图结果显示12名（80%）儿童的冠状动脉异常消失，而2名儿童（13.3%）的动脉瘤有显著缩小。
阿昔单抗可能在KD严重心脏并发症的治疗中发挥重要作用，尽管需要进行前瞻性随机对照研究来全面评估其作用。
