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[川崎病的诊断与管理]

[Diagnosis and management of Kawasaki disease].

作者信息

Bajolle Fanny

机构信息

Unité médicochirurgicale de cardiologie congénitale et pédiatrique ; centre de référence M3C, hôpital Necker-Enfants malades, Paris, France.

出版信息

Rev Prat. 2023 Feb;73(2):179-186.

Abstract

DIAGNOSIS AND MANAGEMENT OF KAWASAKI DISEASE. Kawasaki disease (KD) is a multi-systemic vasculitis predominantly affecting children under 5 years of age. KD's incidence is 30 times higher in Asia than in France. Elective lesional tropism for coronary arteries makes it the leading cause of acquired heart disease in children in developed countries. Diagnosis is based on the presence of fever of 5 days or more and the presence of at least for clinical criteria of cutaneous-mucosal inflammation. KD is believed to be the result of an aberrant inflammatory response to an infectious trigger in a genetically predisposed individual. Timely initiation of treatment with intravenous immunoglobulin has reduced the incidence of coronary artery aneurysms from 25% to 5%. Severe KD requires rapid treatment intensification. Coronary artery lesions are the main determinant of the prognosis. Acute coronary syndrome in adults can be a result of long-term sequelae of the disease. Different imaging techniques are required to adequately follow these patients according to the American Heart Association recommendations.

摘要

川崎病的诊断与管理。川崎病(KD)是一种多系统血管炎,主要影响5岁以下儿童。KD在亚洲的发病率比法国高30倍。对冠状动脉的选择性病变趋向性使其成为发达国家儿童后天性心脏病的主要原因。诊断基于持续5天或更长时间的发热以及至少存在皮肤黏膜炎症的临床标准。KD被认为是遗传易感性个体对感染触发因素的异常炎症反应的结果。及时开始静脉注射免疫球蛋白治疗已将冠状动脉瘤的发生率从25%降至5%。重度KD需要迅速加强治疗。冠状动脉病变是预后的主要决定因素。成人急性冠状动脉综合征可能是该疾病长期后遗症的结果。根据美国心脏协会的建议,需要采用不同的成像技术对这些患者进行充分的随访。

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