该文综合比较了PubMed数据库中检索到的来自中国、阿根廷、欧洲、意大利、日本、西班牙和美国这7个国家/地区的川崎病（Kawasaki disease, KD）指南，分析了它们在KD诊断和治疗方面的异同。结果显示，所有指南均一致推荐单次输注免疫球蛋白2 g/kg作为KD的一线治疗方案，并且均不主张将甲泼尼龙或泼尼松单独作为KD的常规一线治疗药物。然而，在KD的分类、诊断标准以及具体治疗方法等方面，各指南之间存在一定的差异。鉴于此，未来有必要进一步加强国际指南制订的合作，并开展多中心临床研究，以期达成更高层次的专家共识，从而推动KD诊治水平的全面提升。
Abstract
This paper comprehensively compares the Kawasaki disease (KD) guidelines from seven countries/regions, including China, Argentina, Europe, Italy, Japan, Spain, and the United States, as retrieved from the PubMed database. It analyzes the similarities and differences in KD diagnosis and treatment among these guidelines. The results show that all guidelines consistently recommend a single infusion of immunoglobulin at a dosage of 2 g/kg as the first-line treatment for KD, and none advocate for the routine use of methylprednisolone or prednisone as standalone first-line treatment options for KD. However, there are some differences among the guidelines regarding classification, diagnostic criteria, and specific treatment methods for KD. Therefore, it is essential to further strengthen international collaboration in guideline development and conduct multicenter clinical research in the future, aiming to achieve a higher level of expert consensus, thereby promoting the enhancement of KD diagnosis and treatment.
关键词
川崎病 /
诊断 /
治疗 /
指南 /
解读 /
儿童
Key words
Kawasaki disease /
Diagnosis /
Treatment /
Guideline /
Interpretation /
Child
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参考文献
1 陕西省川崎病诊疗中心/陕西省人民医院儿童病院, 国家儿童医学中心/首都医科大学附属北京儿童医院, 上海交通大学医学院附属儿童医院, 等. 中国儿童川崎病诊疗循证指南（2023年）[J]. 中国当代儿科杂志, 2023, 25(12): 1198-1210. PMID: 38112136. PMCID: PMC10731970. DOI: 10.7499/j.issn.1008-8830.2309038.
2 Sociedad Argentina de Pediatría, Sociedad Argentina de Cardiología. Kawasaki disease: interdisciplinary and intersocieties consensus (clinical guidelines). Brief version[J]. Arch Argent Pediatr, 2016, 114(4): 385-390. PMID: 27399018. DOI: 10.5546/aap.2016.385.
3 Marchesi A, Tarissi de Jacobis I, Rigante D, et al. Kawasaki disease: guidelines of Italian Society of Pediatrics, part II: treatment of resistant forms and cardiovascular complications, follow-up, lifestyle and prevention of cardiovascular risks[J]. Ital J Pediatr, 2018, 44(1): 103. PMID: 30157893. PMCID: PMC6116479. DOI: 10.1186/s13052-018-0529-2.
4 Marchesi A, Tarissi de Jacobis I, Rigante D, et al. Kawasaki disease: guidelines of the Italian Society of Pediatrics, part I: definition, epidemiology, etiopathogenesis, clinical expression and management of the acute phase[J]. Ital J Pediatr, 2018, 44(1): 102. PMID: 30157897. PMCID: PMC6116535. DOI: 10.1186/s13052-018-0536-3.
5 Kobayashi T, Ayusawa M, Suzuki H, et al. Revision of diagnostic guidelines for Kawasaki disease (6th revised edition)[J]. Pediatr Int, 2020, 62(10): 1135-1138. PMID: 33001522. DOI: 10.1111/ped.14326.
6 McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association[J]. Circulation, 2017, 135(17): e927-e999. PMID: 28356445. DOI: 10.1161/CIR.0000000000000484.
7 de Graeff N, Groot N, Ozen S, et al. European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease: the SHARE initiative[J]. Rheumatology (Oxford), 2019, 58(4): 672-682. PMID: 30535127. DOI: 10.1093/rheumatology/key344.
8 Barrios Tascón A, Centeno Malfaz F, Rojo Sombrero H, et al. National consensus on the cardiological treatment and follow-up of Kawasaki disease[J]. An Pediatr (Engl Ed), 2018, 89(3): 188.e1-188.e22. PMID: 29778491. DOI: 10.1016/j.anpedi.2018.04.003.
基金
湖北省儿科医疗联盟课题（HPAMRP202117）；上海金山区医学重点专科项目（JSZK2023A04）。
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