Similarities and differences between MIS-C and KD: a systematic review and meta-analysis.
Similarities and differences between MIS-C and KD: a systematic review and meta-analysis.
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DOI：
10.1186/s12969-022-00771-x
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发表时间：
2022-12-05
影响因子：
2.5
通讯作者：
Gong, Fangqi
中科院分区：
文献类型：
--
作者：
Tong, Tong;Yao, Xuefeng;Lin, Zhe;Tao, Yijing;Xu, Jiawen;Xu, Xiao;Fang, Zhihao;Geng, Zhimin;Fu, Songling;Wang, Wei;Xie, Chunhong;Zhang, Yiying;Wang, Yujia;Gong, Fangqi
儿童多系统炎症综合征（multiple system inflammatory syndrome, MIS-C）是一种临床表现类似川崎病（Kawasaki disease， KD）的新综合征，难以区分。该研究旨在比较misc与KD的人口学特征、临床特征、实验室特征、心脏并发症和治疗方法。在2022年2月28日之前通过检索PubMed、EMBASE等选择研究。使用Review Manager 5.4软件和STATA 14.0进行统计分析。14项研究共纳入2928名参与者。misc患者年龄偏大，性别比例差异无统计学意义。在临床特征方面，misc患者以呼吸道、胃肠道症状和休克多见。同时，结膜炎的发生率低于KD患者。misc患者淋巴细胞计数、血小板（PLT）计数、红细胞沉降率（ESRs）、丙氨酸转氨酶（ALT）和白蛋白水平较低，而天冬氨酸转氨酶（AST）、n端前b型利钠肽（NT-pro-BNP）、肌钙蛋白、c反应蛋白（CRP）、d -二聚体、纤维蛋白原、铁蛋白和肌酐水平较高。misc患者左心室功能障碍、瓣膜反流、心包积液、心肌炎和心包炎的发生率较高。misc患者冠状动脉病变（CAL）发生率较低[OR (95% CI): 0.52 (0.29, 0.93), p =0.03]，急性期相似。misc患者糖皮质激素（GCs）使用率较高，静脉注射免疫球蛋白（IVIG）使用率较低。MIS-C和KD之间存在特异性差异，这可能有助于临床医生准确识别MIS-C并进一步开展机制研究。在线版本包含补充材料，可在10.1186/s12969-022-00771-x获得。
Multisystem inflammatory syndrome in children (MIS-C) is a new syndrome with some clinical manifestations similar to Kawasaki disease (KD), which is difficult to distinguish. The study aimed to characterize the demographic characteristics, clinical characteristics, laboratory features, cardiac complications, and treatment of MIS-C compared with KD. Studies were selected by searching the PubMed, EMBASE and so on before February 28, 2022. Statistical analyses were performed using Review Manager 5.4 software and STATA 14.0. Fourteen studies with 2928 participants were included. MIS-C patients tended to be older and there was no significant difference in the sex ratio. In terms of clinical characteristics, MIS-C patients were more frequently represented with respiratory, gastrointestinal symptoms and shock. At the same time, they had a lower incidence of conjunctivitis than KD patients. MIS-C patients had lower lymphocyte counts, platelet (PLT) counts, erythrocyte sedimentation rates (ESRs), alanine transaminase (ALT), and albumin levels and had higher levels of aspartate transaminase (AST), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), troponin, C-reactive protein (CRP), D-dimer, fibrinogen, ferritin, and creatinine. MIS-C patients had a higher incidence of left ventricle (LV) dysfunction, valvular regurgitation, pericardial effusion, myocarditis, and pericarditis. The incidence of coronary artery lesion (CAL) was lower in MIS-C patients [OR (95% CI): 0.52 (0.29, 0.93), p =0.03], while it was similar in the acute period. MIS-C patients had higher utilization of glucocorticoids (GCs) and lower utilization of intravenous immune globulin (IVIG). There were specific differences between MIS-C and KD, which might assist clinicians with the accurate recognition of MIS-C and further mechanistic research. The online version contains supplementary material available at 10.1186/s12969-022-00771-x.
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