川崎病专家共识委员会和《中华当代儿科杂志》--关于静脉注射免疫球蛋白、阿司匹林和糖皮质激素的专家共识

Shuying Ren, Fangming Deng, Zhongdong Du, Xiaodong Yang, Lijian Xie, Hong Wang, Fuyong Jiao
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摘要

导言和目的。川崎病(Kawasaki disease,KD)是一种病因不明的急性血管炎,通常发生于 5 岁以下儿童。本文将总结中国关于 KD 的三个共识。材料与方法。共识检索的英文数据库包括 UpToDate、BMJ Clinical Evidence、National Guideline Clearinghouse、Joanna Briggs Institute Library、Cochrane Library 和 PubMed 等;中文数据库包括中国生物医学文献服务网、中国知网、万方数据库等。所有文献检索于 2022 年 2 月 28 日结束。文献分析。KD 是儿童常见的后天性心脏病,可导致冠状动脉损伤等严重并发症。然而,静脉注射免疫球蛋白(IVIG)联合口服阿司匹林(Asp)是目前公认的治疗KD急性期最有效的方法,也是预防心血管并发症的一线治疗方法。糖皮质激素(GC)主要用于冠状动脉瘤(CAA)风险高、无免疫球蛋白反应和确诊为 CAA 的 KD 患者。目前,不同国家已就 KD 的诊断和治疗达成共识指南。本文总结了中国关于阿司匹林、糖皮质激素和 IVIG 治疗川崎病的相关专家共识。结论。目前,关于川崎病的治疗机制、最佳治疗时机和用药剂量,文献中仍存在不一致的观点。
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Consensus Committee of experts on Kawasaki Disease and Chinese Journal of Contemporary Pediatrics – the expert consensuses on intravenous immunoglobulin, aspirin, and glucocorticoid
Introduction and aim. Kawasaki disease (KD) is an acute vasculitis with unknown etiology, usually occurring in chil dren under 5 years old. This article will summarize the three consensuses formulated in China about KD. Material and methods. English databases for consensus search include UpToDate, BMJ Clinical Evidence, National Guideline Clearinghouse, Joanna Briggs Institute Library, Cochrane Library, and PubMed, etc.; Chinese databases in clude China Biomedical Literature Service, China Knowledge Network, Wanfang database, etc. All literature searches ended on February 28, 2022. Analysis of the literature. KD is a common acquired heart disease in children and can lead to severe complications such as coronary injury. However, intravenous immunoglobulin (IVIG) combined with oral aspirin (Asp) is currently recognized as the most effective treatment in KD acute stage and the first-line treatment to prevent cardiovascular complications. Glucocorticoid (GC) is mainly used for KD patients with a high risk of coronary artery aneurysm (CAA), no immunoglobulin response, and confirmed CAA. There are already consensus guidelines on diagnosing and treat ing KD in different countries. This article summarizes the relevant expert consensus on aspirin, glucocorticoids and IVIG for the treatment of Kawasaki disease in China. Conclusion. Still, there are inconsistent opinions in the literature on the mechanism, optimal timing, and dosage of medication for KD.
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