Clinical Manifestations of Kawasaki Disease Shock Syndrome
Clinical Manifestations of Kawasaki Disease Shock Syndrome
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DOI：
10.1177/0009922817729483
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发表时间：
2018-04-01
影响因子：
1.6
通讯作者：
Yu, Hai-Guo
中科院分区：
文献类型：
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作者：
Ma, Le;Zhang, Ya-Yuan;Yu, Hai-Guo
为明确川崎病休克综合征（KDSS）患儿的临床特征，进行了一项病例对照研究。选择南京市儿童医院住院患者。分析了人口统计学特征、临床表现、实验室数据、心血管结果和治疗。与对照组相比，KDSS患者年龄更大，皮疹更严重。白细胞增多、嗜中性粒细胞增多和低白蛋白血症的比例较高，白细胞计数、C反应蛋白、脑钠肽和铁蛋白水平也较高。KDSS患者心律失常的发生率更高，冠状动脉受累更严重。所有病例患者均接受阿司匹林、糖皮质激素和静脉注射免疫球蛋白，33.3%需要白蛋白，90.4%需要血管活性药物输注。总之，KDSS患者在急性期可能有更严重的炎症反应。短期使用糖皮质激素对抑制炎症反应可能很重要。白蛋白和血管活性药物可用于抢救休克。
A case-control study was performed to ascertain clinical features of children who had been diagnosed as Kawasaki disease shock syndrome (KDSS), a severe condition related to Kawasaki disease (KD). Hospitalized patients were selected in Nanjing Children's Hospital. Demographic characteristics, clinical presentation, laboratory data, cardiovascular findings, and therapies were analyzed. Compared with the control group, KDSS patients were older and had more serious skin rash. The proportions of leukocytosis, neutrophilia, and hypoalbuminemia was higher, as was the level of while blood cell count, C-reactive protein, brain natriuretic peptide, and ferroprotein. KDSS patients had higher incidence of arrhythmias and more severe coronary artery involvement. All case patients received aspirin, glucocorticoid, and intravenous immunoglobulin, 33.3% required albumin, and 90.4% needed vasoactive infusions. In conclusion, KDSS patients may have more serious inflammatory responses in the acute phase. Short-term use of glucocorticoid may be important in inhibiting the inflammatory response. Albumin and vasoactive drugs are useful to rescue shock.