新型冠状病毒感染后儿童多系统炎症综合征4例

doi:10.7499/j.issn.1008-8830.2302126

摘要
图/表
参考文献(14)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (459 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的探讨新型冠状病毒感染后儿童多系统炎症综合征（multisystem inflammatory syndrome in children，MIS-C）患儿的临床特征及诊治策略。方法对徐州医科大学附属徐州儿童医院心血管内科2023年1—2月收治的4例MIS-C患儿的病例资料进行回顾性分析。结果 4例患儿均伴有多脏器功能受累及炎症指标升高，入院后接受川崎病标准治疗方案效果不理想，其中2例予2次静脉注射免疫球蛋白冲击治疗，4例均加用糖皮质激素抗炎治疗，积极治疗后患儿预后良好。结论 MIS-C常出现在新型冠状病毒感染后4~6周或更长时间，及时在川崎病标准治疗方案基础上加强抗炎治疗可取得良好治疗效果。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王飞
	刘璐
	薛莹
	石丹
	安新江

关键词 ：儿童多系统炎症综合征, 新型冠状病毒, 类川崎病, 儿童

Abstract：Objective To investigate the clinical features and treatment strategies of multisystemic inflammatory syndrome in children (MIS-C) after severe acute respiratory syndrome coronavirus 2 infection. Methods A retrospective analysis was performed on the medical data of four children with MIS-C who were admitted to the Department of Cardiology, Xuzhou Children's Hospital, Xuzhou Medical University from January to February 2023. Results All four children had multiple organ involvements and elevated inflammatory markers, with a poor response to standard therapy for Kawasaki disease after admission. Two children were treated with intravenous immunoglobulin therapy pulse therapy twice, and all four children were treated with glucocorticoids. The children had a good prognosis after the treatment. Conclusions MIS-C often appears within 4-6 weeks or a longer time after severe acute respiratory syndrome coronavirus 2 infection, and anti-inflammatory therapy in addition to the standard treatment regimen for Kawasaki disease can help to achieve a favorable treatment outcome.

Key words： Multisystemic inflammatory syndrome in children Severe acute respiratory syndrome coronavirus 2 Kawasaki-like disease Child

收稿日期: 2023-02-22

作者简介: 王飞，男，硕士，主治医师。Email：xzwfei@hotmail.com；

引用本文:

王飞,刘璐,薛莹等. 新型冠状病毒感染后儿童多系统炎症综合征4例[J]. 中国当代儿科杂志, 2023, 25(7): 685-688.

WANG Fei,LIU Lu,XUE Ying et al. Multisystemic inflammatory syndrome in children after severe acute respiratory syndrome coronavirus 2 infection: a clinical analysis of four cases[J]. CJCP, 2023, 25(7): 685-688.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2302126 或 http://www.zgddek.com/CN/Y2023/V25/I7/685

	Brodsky NN, Ramaswamy A, Lucas CL. The mystery of MIS-C post-SARS-CoV-2 infection[J]. Trends Microbiol, 2020, 28(12): 956-958. PMID: 33190685. PMCID: PMC7556780. DOI: 10.1016/j.tim.2020.10.004.
	Whittaker E, Bamford A, Kenny J, et al. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2[J]. JAMA, 2020, 324(3): 259-269. PMID: 32511692. PMCID: PMC7281356. DOI: 10.1001/jama.2020.10369.
	Viner RM, Whittaker E. Kawasaki-like disease: emerging complication during the COVID-19 pandemic[J]. Lancet, 2020, 395(10239): 1741-1743. PMID: 32410759. PMCID: PMC7220168. DOI: 10.1016/S0140-6736(20)31129-6.
	4 World Health Organization. Multisystem inflammatory syndrome in children and adolescents with COVID-19[EB/OL]. (2020-05-15)[2023-02-15]. https://www.who.int/publications/i/item/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19.
	Riphagen S, Gomez X, Gonzalez-Martinez C, et al. Hyperinflammatory shock in children during COVID-19 pandemic[J]. Lancet, 2020, 395(10237): 1607-1608. PMID: 32386565. PMCID: PMC7204765. DOI: 10.1016/S0140-6736(20)31094-1.
	6 CDC Health Alert Network. Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19)[EB/OL]. (2020-05-14)[2023-02-19]. https://emergency.cdc.gov/han/2020/han00432.asp.
	Feldstein LR, Rose EB, Horwitz SM, et al. Multisystem inflammatory syndrome in U.S. children and adolescents[J]. N Engl J Med, 2020, 383(4): 334-346. PMID: 32598831. PMCID: PMC7346765. DOI: 10.1056/NEJMoa2021680.
	8 王亮, 沈永明. 类川崎病——儿童多系统炎症综合征诊疗相关研究现状[J]. 临床儿科杂志, 2021, 39(10): 792-796. DOI: 10.3969/j.issn.1000-3606.2021.10.019.
	Nakra NA, Blumberg DA, Herrera-Guerra A, et al. Multi-system inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: review of clinical presentation, hypothetical pathogenesis, and proposed management[J]. Children (Basel), 2020, 7(7): 69. PMID: 32630212. PMCID: PMC7401880. DOI: 10.3390/children7070069.
	Colmenero I, Santonja C, Alonso-Ria?o M, et al. SARS-CoV-2 endothelial infection causes COVID-19 chilblains: histopathological, immunohistochemical and ultrastructural study of seven paediatric cases[J]. Br J Dermatol, 2020, 183(4): 729-737. PMID: 32562567. PMCID: PMC7323219. DOI: 10.1111/bjd.19327.
	Sharifkashani S, Bafrani MA, Khaboushan AS, et al. Angiotensin-converting enzyme 2 (ACE2) receptor and SARS-CoV-2: potential therapeutic targeting[J]. Eur J Pharmacol, 2020, 884: 173455. PMID: 32745604. PMCID: PMC7834210. DOI: 10.1016/j.ejphar.2020.173455.
	12 蒋荣猛, 谢正德, 姜毅, 等. 儿童新型冠状病毒感染诊断、治疗和预防专家共识(第四版)[J]. 中华实用儿科临床杂志, 2022, 37(14): 1053-1065. DOI: 10.3760/cma.j.cn101070-20220610-00698.
	13 王超, 秦虹, 张兴和, 等. 新型冠状病毒感染相关儿童多系统炎症综合征1例[J]. 中华临床感染病杂志, 2022, 15(5): 385-387. DOI: 10.3760/cma.j.issn.1674-2397.2022.05.010.
	Fagherazzi G, Goetzinger C, Rashid MA, et al. Digital health strategies to fight COVID-19 worldwide: challenges, recommendations, and a call for papers[J]. J Med Internet Res, 2020, 22(6): e19284. PMID: 32501804. PMCID: PMC7298971. DOI: 10.2196/19284.