摘要
川崎病（KD）是一种病因未明、以全身血管炎性病变为主要病理改变的儿童急性发热性疾病。KD常累及冠状动脉，若未及时治疗，患儿可发生冠脉损伤（CAL）。目前急性期KD标准治疗方案为静脉用丙种球蛋白（IVIG）联合口服阿司匹林，但仍有10％~20％的患儿对IVIG无反应，并且这部分患儿发生CAL的风险增高。文献报道有多种IVIG无反应型KD的治疗方法，如二次IVIG治疗、糖皮质激素、英夫利昔单抗、免疫抑制剂和血浆置换等，然而具体治疗方案仍无定论。文章综述IVIG无反应型KD的治疗。
Kawasaki disease （KD） is a childhood acute febrile illness with systemic vasculitis of an unknown etiology as the main pathological changes. KD often affects the coronary artery and, if not treated in time, the patients may develop coronary artery lesion （CAL）. Currently, the standard treatment for the acute phase of KD are intravenous immunoglobulin （IVIG） and oral aspirin. Nevertheless, there are still 10% to 20% of patients unresponsive to IVIG, and risk of CAL was increased in these children, Literatures have reported a variety of therapeutic options for IVIG resistant KD, such as secondary IVIG therapy, gluco- corticoid, infliximab, immunosuppressive agents, and plasma exchange. However, the outcomes of these therapies remain incon- clusive. This article reviewed the progress in the treatment of IVIG resistant KD.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2016年第1期68-72,共5页
Journal of Clinical Pediatrics
基金
上海卫生系统先进适宜技术推广项目(No.2013SY062)
上海交通大学医工交叉基金(No.YG2013MS73)
上海市卫生和计划生育委员会面上项目(No.201540099)
关键词
川崎病
静脉注射丙种球蛋白无反应
治疗
Kawasaki disease
intravenous immunoglobulin-resistant
treatment
