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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Associa
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Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Associa

机译：川崎病的诊断，治疗和长期治疗：美国心协会青年心血管病委员会风湿热，心内膜炎和川崎病委员会的医疗专业人员声明

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BACKGROUND: Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in approximately 15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. METHODS AND RESULTS: A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for > or =5 days and < or =4 classic criteria should undergo echocardiography [correction], receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor-alpha antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. CONCLUSIONS: Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients.
机译：背景：川崎病是儿童的一种急性自限性血管炎，其特征是发烧，双侧非渗出性结膜炎，嘴唇和口腔粘膜红斑，四肢改变，皮疹和宫颈淋巴结肿大。未经治疗的儿童中约有15％至25％会发生冠状动脉瘤或扩张，并可能导致缺血性心脏病或猝死。方法和结果：召开了一个多学科专家委员会，以修订美国心脏协会对川崎病的诊断，治疗和长期治疗的建议。写作小组提出了一种新的算法，可以帮助临床医生确定哪些发烧超过或等于5天且≤或等于4个经典标准的儿童应接受超声心动图检查[校正]，接受静脉丙种球蛋白（IVIG）治疗或两者同时用于川崎病。写作小组回顾了有关急性川崎病儿童以及尽管使用IVIG进行初始治疗但仍持续或复发发烧的儿童的初始治疗的可用数据，包括IVIG再治疗和皮质类固醇，肿瘤坏死因子-α拮抗剂的治疗，以及阿昔单抗。川崎病患者的长期治疗根据冠状动脉受累程度而定;有关抗血小板和抗凝治疗，身体活动，随访评估以及评估心脏疾病的适当诊断程序的建议根据风险分层进行了分类。结论：有关川崎病患者的初始评估，急性期治疗和长期治疗的建议旨在帮助医生了解可接受的护理川崎病患者的方法范围。病例管理的最终决定必须由医生根据个别患者的特殊情况做出。

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