《2021年美国风湿病学会/血管炎基金会川崎病管理指南》解读  

Interpretation of the 2021 American College of Rheumatology/Vasculitis Foundation guideline for the management of Kawasaki disease

作　　者：潘炎[1] 严晓华[2] 郭和昌 丁艳[5] 焦富勇[2] PAN Yan;YAN Xiaohua;KUO Hochang;DING Yan;JIAO Fuyong(Department of Pediatrics,the First Affiliated Hospital of Yangtze University,Jingzhou 434000,Hubei Province,China;Children's Hospital of Shaanxi Provincial People's Hospital/Diagnosis and Treatment Center of Kawasaki Disease of Shaanxi Province,Xi'an 710068,China;College of Medicine,Chang Gung University,Taoyuan 33302,Taiwan,China;Kawasaki Disease Center and Department of Pediatrics,Kaohsiung Chang Gung Memorial Hospital,Kaohsiung,83301,Taiwan,China;Department of Rheumatology and Immunology,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430016,China)

机构地区：[1]长江大学附属第一医院儿科,湖北荆州434000 [2]陕西省人民医院儿童病院/陕西省川崎病诊疗中心,西安710068 [3]台湾长庚大学医学院,中国台湾桃园33302 [4]台湾高雄长庚医院川崎症中心,中国台湾高雄83301 [5]华中科技大学同济医学院附属武汉儿童医院风湿免疫科,武汉430016

出　　处：《医学新知》2024年第11期1284-1292,共9页New Medicine

基　　金：湖北省儿科医疗联盟课题(HPAMRP202117)。

摘　　要：2021年美国风湿病学会/血管炎基金会发布了川崎病(Kawasaki disease,KD)疾病管理指南,为KD的治疗提供了循证建议和专家指导。指南重点关注风湿病学家更常处理的临床情况,指出KD患者均应接受静脉注射免疫球蛋白(intravenous immunoglobulin,IVIg)的初始治疗。此外,指南还为KD或疑似KD的治疗制定了7项强烈建议和4项有条件的建议。强烈建议包括及时治疗不完全KD、使用阿司匹林治疗,以及在不明原因的巨噬细胞活化综合征或休克的情况下行超声心动图检查。有条件的推荐包括对KD和IVIg抵抗和(或)具有冠状动脉瘤高危特征的患者使用IVIg和其他辅助药物。这些建议为疑似或确诊KD患者的诊断策略、药物的选择和超声心动图的使用提供了指导。本文参考国内外文献对指南重点内容进行解读,以便于我国儿科医生借鉴。The 2021 American College of Rheumatology/Vasculitis Foundation guidelines for the management of Kawasaki disease(KD)provided evidence-based recommendations and expert guidance for the treatment of KD,with a focus on clinical situations more commonly handled by rheumatologists.The good practice statement confirmed that all KD patients should receive initial treatment with intravenous immunoglobulin(IVIg).Additionally,the guideline included 7 strong recommendations and 4 conditional recommendations for the treatment of KD or suspected KD.The strong recommendations emphasized the timely treatment of incomplete KD,the use of aspirin therapy,and the performance of echocardiography in cases of macrophage activation syndrome or shock of unknown origin.The conditional recommendations suggested the use of IVIg and other adjunctive therapies for patients with KD who were resistant to IVIg and/or had high-risk features for coronary artery aneurysms.This guideline provided direction on diagnostic strategies,drug selection,and the use of echocardiography for suspected or confirmed KD patients.This article referenced both domestic and international literature to interpret the key points of the guideline,aiming to provide useful insights for pediatricians in China.

关 键 词：川崎病 指南 解读 诊断 治疗 儿童 

分 类 号：R593.1[医药卫生—内科学]