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儿童川崎病合并巨噬细胞活化综合征患儿在重症监护病房与普通病房住院的比较研究:一项为期一年的回顾性研究。

A Comparative Study of Children with MIS-C between Admitted to the Pediatric Intensive Care Unit and Pediatric Ward: A One-Year Retrospective Study.

机构信息

Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir 35210, Turkey.

Department of Pediatric Cardiology, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir 35210, Turkey.

出版信息

J Trop Pediatr. 2021 Dec 8;67(6). doi: 10.1093/tropej/fmab104.

Abstract

OBJECTIVES

This descriptive study aimed to compare the clinical and laboratory features of the children with the multisystem inflammatory syndrome in children (MIS-C), requiring pediatric intensive care unit (PICU), admission with the MIS-C patients who did not require PICU admission.

PATIENTS AND METHODS

This study was conducted between March 2020 and February 2021 at the University of Health Sciences Dr. Behçet Uz Children's Hospital, a referral center for pediatric infectious diseases in the Aegean Region of Turkey. All hospitalized patients aged 18 years old or less with MIS-C according to the definition of the universal guidelines were included in the study. Data of the patients with the diagnosis of MIS-C were recorded and collected from the electronic medical records of the hospital. The data included demographic characteristics, presenting signs and symptoms, laboratory findings and clinical data.

RESULTS

A total of 58 patients with MIS-C were included in this study. Thirty-eight (65.5%) patients were male. The median age was 6 years (2 months-16 years). The patients admitted to PICU were 15 (25.9%). The rate of pulmonary involvement was 81.3% (n = 13) in the PICU group. The median procalcitonin, C-reactive protein, erythrocyte sedimentation rate, D-Dimer and ferritin values were significantly higher in the PICU group compared to non-PICU group (p < 0.001, p = 0.02, p < 0.001, p = 0.006 and p = 0.031).

CONCLUSIONS

Besides the depressing cardiac functions reported before, the pulmonary involvement and signs of shock are important factors for PICU admission in children with MIS-C.

摘要

目的

本描述性研究旨在比较需要儿科重症监护病房(PICU)入院的儿童多系统炎症综合征(MIS-C)患儿与无需 PICU 入院的 MIS-C 患儿的临床和实验室特征。

患者和方法

本研究于 2020 年 3 月至 2021 年 2 月在土耳其爱琴海地区儿科传染病转诊中心健康科学大学 Dr. Behçet Uz 儿童医院进行。所有符合通用指南定义的 18 岁或以下住院的 MIS-C 患儿均纳入本研究。从医院电子病历中记录和收集了 MIS-C 患儿的诊断数据。数据包括人口统计学特征、表现出的体征和症状、实验室发现和临床数据。

结果

本研究共纳入 58 例 MIS-C 患儿。38 例(65.5%)为男性。中位年龄为 6 岁(2 个月至 16 岁)。15 例(25.9%)患儿入住 PICU。PICU 组肺部受累的发生率为 81.3%(n=13)。与非 PICU 组相比,PICU 组降钙素原、C 反应蛋白、红细胞沉降率、D-二聚体和铁蛋白中位数显著更高(p<0.001,p=0.02,p<0.001,p=0.006 和 p=0.031)。

结论

除了之前报道的心脏功能抑制外,肺部受累和休克迹象是儿童 MIS-C 患儿入住 PICU 的重要因素。

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