川崎病并发巨噬细胞活化综合征的研究进展
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摘要
川崎病是一种全身性血管炎,以心血管系统损害最为严重,约15%-20%未经治疗的患儿发生冠状动脉损伤,是目前儿童获得性心脏疾病的首要因素。巨噬细胞活化综合征是风湿性疾病的一种严重危及患儿生命的并发症,而关于川崎病并发巨噬细胞活化综合征的相关病例报道少见,其疾病的发病机制尚未明确,缺乏相应的诊疗指南。本文就川崎病并发巨噬细胞活化综合征的病因、发病机制、诊治及预后作简要阐述。
Kawasaki disease is a kind of systemic vasculitis, with the most serious damage to the cardiovascular system. It is the first cause of acquired heart disease in children. Macrophage activation syndrome is a complication of rheumatic disease that seriously endangers the lives of children. The cases of Kawasaki disease complicated with macrophage activation syndrome are rare. The pathogenesis of Kawasaki disease has not been clarified, and there is no corresponding diagnosis and treatment guidelines. This article reviews the etiology, pathogenesis, diagnosis, treatment and prognosis of Kawasaki disease complicated with macrophage activation syndrome.
Kawasaki disease is a kind of systemic vasculitis, with the most serious damage to the cardiovascular system. It is the first cause of acquired heart disease in children. Macrophage activation syndrome is a complication of rheumatic disease that seriously endangers the lives of children. The cases of Kawasaki disease complicated with macrophage activation syndrome are rare. The pathogenesis of Kawasaki disease has not been clarified, and there is no corresponding diagnosis and treatment guidelines. This article reviews the etiology, pathogenesis, diagnosis, treatment and prognosis of Kawasaki disease complicated with macrophage activation syndrome.
引文
[1]杨波,朱义杰,罗军,等.川崎病流行病学、病因和发病机制的新进展[J].临床儿科杂志,2014,32(2):189-192.
[2]张清友,简佩君,杜军保.风湿热、心内膜炎及川崎病委员会,美国心脏病学会及美国儿科学会川崎病的诊断、治疗及长期随访指南介绍[J].实用儿科临床杂志,2012,27(13):1049-1056.
[3]林瑶,李晓惠,石琳,等.2017年版《川崎病的诊断、治疗及远期管理--美国心脏协会对医疗专业人员的科学声明》解读[J].中国实用儿科杂志,2017,32(9):641-648.
[4]王宏伟,施虹.巨噬细胞活化综合征[J].实用儿科临床杂志,2006,(9):519-521.
[5]何晓琥.重视对巨噬细胞活化综合征的认识[J].中华儿科杂志,2006,(11):801-802.
[6]Ramanan av,Rosenblum ND,Feldman BM,et al.Favorableoutcome in patients with renal involvement complicating macro-phage activation syndrome in systemic onset juvenile rheumatoidarthritis[J].Arthritis Rheum,2004,31(10):2068-2070.
[7]Hadchouel M,Prieur AM,Griscelli C,et al.Acute hemorrhagic,hepatic,and neurologic manifestations in juvenile rheumatoid arthritispossi-ble relationship to drugs or infection[[J].J Pediatr,1985,106(4):561-566.
[8]Stéphan JL,Zeller J,Hubert P,et al..Macrophage activation syndrome and rheumatic disease in childhood:a report of four new cases[J].Clin Exp Rheumatol,1993,11(4):451.
[9]tephanJL,ZellerJ,HubertP,et al.Reactive haemophagocytic syndrome in children with inflammatory disorders.A retrospective study of 24 patients[J].Rheumatology(Oxford),2001,40(11):1285-1292.
[10]Sawhney S,Woo P,Murray KJ.Macrophage activation syndrome a potentially fatal complication of rheumatic disorders[J].Arch Dis Child,2001,85(5):421-426.
[11]赵怡雯,杨丽云,崔娟红.穿孔素基因及蛋白功能研究进展[J].中国组织工程研究与临床康复,2011,15(44):8355-8360.
[12]Vastert SJ,van Wijk R,D'Urbano LE,et al.Mutations in theperforin gene can be linked to macrophage activation syndromein patients with systemic onset juvenile idiopathic arthritis[J].Rheumatology(Oxford),2010,49(3):441-449.
[13]Aa Grom,J Villanueva,S Lee,et al.NK cell dysfunction in patients with systemic onset juvenile rheumatoid arthritis and mac-rophage activation syndrome[J].J Pediatr,2003,142(3):292-296.
[14]成银萍,唐雪梅.巨噬细胞活化综合征的研究进展[J].临床儿科杂志,2012,31(10):2068-2070.
[15]乔东丽,李亚蕊.川崎病并发巨噬细胞活化综合征1例[J].山西医科大学学报,2017,48(2):199-200.
[16]A Ravelli,,F MinoiaI,S Davi,et al.2016 Classification criteriafor macrophage activation syndrome complicating systemic juvenile idio.pathic arthritis:a european league against rheumatism american college of rheumatology paediatric rheumatology international trials organisation collaborative initiative[J].Arthritis Rheum,2016,68(3):566-567.
[17]施虹,程佩萱,王宏伟.巨噬细胞活化综合征[J].实用儿科临床杂志,2006,21(3):179-182.
[18]李彩凤,何晓琥.风湿性疾病的一种严重并发症--巨噬细胞活化综合征[J].中华儿科杂志,2006,44(11):824-827.
[19]李彩凤.巨噬细胞活化综合征诊治进展[J].中国实用儿科杂志,2010,(3):237-240.
[20]赵亚玲,梁琨,徐静,等.川崎病发生巨噬细胞活化综合征的危险因素分析[J].中国临床新医学,2010,3(10):947-950.
[21]黄跃东,吴晓云.川崎病并发巨噬细胞活化综合征研究进展[J].现代医药卫生,2018,34(8):1187-1189.
[22]张艳艳,卢彦敏,李自普.川崎病并发巨噬细胞活化综合征(附3例报告并文献分析)[J].青岛大学医学院学报,2011,47(5):444-446,449.
[23]陈莉,王献民,蓝明平.川崎病并巨噬细胞活化综合征1例并文献复习[J].名医,2018,(4):69-70.
[24]焦莉平,沈颖,易著文.2011中国儿童血液净化论坛会议纪要[J].中国实用儿科杂志,2011,26(8):628-629.
[25]袁丽华,徐元芹,王岩艳,等.川崎病并巨噬细胞活化综合征3例报告并文献复习[J].青岛大学医学院学报,2012,48(6):544-545.
[2]张清友,简佩君,杜军保.风湿热、心内膜炎及川崎病委员会,美国心脏病学会及美国儿科学会川崎病的诊断、治疗及长期随访指南介绍[J].实用儿科临床杂志,2012,27(13):1049-1056.
[3]林瑶,李晓惠,石琳,等.2017年版《川崎病的诊断、治疗及远期管理--美国心脏协会对医疗专业人员的科学声明》解读[J].中国实用儿科杂志,2017,32(9):641-648.
[4]王宏伟,施虹.巨噬细胞活化综合征[J].实用儿科临床杂志,2006,(9):519-521.
[5]何晓琥.重视对巨噬细胞活化综合征的认识[J].中华儿科杂志,2006,(11):801-802.
[6]Ramanan av,Rosenblum ND,Feldman BM,et al.Favorableoutcome in patients with renal involvement complicating macro-phage activation syndrome in systemic onset juvenile rheumatoidarthritis[J].Arthritis Rheum,2004,31(10):2068-2070.
[7]Hadchouel M,Prieur AM,Griscelli C,et al.Acute hemorrhagic,hepatic,and neurologic manifestations in juvenile rheumatoid arthritispossi-ble relationship to drugs or infection[[J].J Pediatr,1985,106(4):561-566.
[8]Stéphan JL,Zeller J,Hubert P,et al..Macrophage activation syndrome and rheumatic disease in childhood:a report of four new cases[J].Clin Exp Rheumatol,1993,11(4):451.
[9]tephanJL,ZellerJ,HubertP,et al.Reactive haemophagocytic syndrome in children with inflammatory disorders.A retrospective study of 24 patients[J].Rheumatology(Oxford),2001,40(11):1285-1292.
[10]Sawhney S,Woo P,Murray KJ.Macrophage activation syndrome a potentially fatal complication of rheumatic disorders[J].Arch Dis Child,2001,85(5):421-426.
[11]赵怡雯,杨丽云,崔娟红.穿孔素基因及蛋白功能研究进展[J].中国组织工程研究与临床康复,2011,15(44):8355-8360.
[12]Vastert SJ,van Wijk R,D'Urbano LE,et al.Mutations in theperforin gene can be linked to macrophage activation syndromein patients with systemic onset juvenile idiopathic arthritis[J].Rheumatology(Oxford),2010,49(3):441-449.
[13]Aa Grom,J Villanueva,S Lee,et al.NK cell dysfunction in patients with systemic onset juvenile rheumatoid arthritis and mac-rophage activation syndrome[J].J Pediatr,2003,142(3):292-296.
[14]成银萍,唐雪梅.巨噬细胞活化综合征的研究进展[J].临床儿科杂志,2012,31(10):2068-2070.
[15]乔东丽,李亚蕊.川崎病并发巨噬细胞活化综合征1例[J].山西医科大学学报,2017,48(2):199-200.
[16]A Ravelli,,F MinoiaI,S Davi,et al.2016 Classification criteriafor macrophage activation syndrome complicating systemic juvenile idio.pathic arthritis:a european league against rheumatism american college of rheumatology paediatric rheumatology international trials organisation collaborative initiative[J].Arthritis Rheum,2016,68(3):566-567.
[17]施虹,程佩萱,王宏伟.巨噬细胞活化综合征[J].实用儿科临床杂志,2006,21(3):179-182.
[18]李彩凤,何晓琥.风湿性疾病的一种严重并发症--巨噬细胞活化综合征[J].中华儿科杂志,2006,44(11):824-827.
[19]李彩凤.巨噬细胞活化综合征诊治进展[J].中国实用儿科杂志,2010,(3):237-240.
[20]赵亚玲,梁琨,徐静,等.川崎病发生巨噬细胞活化综合征的危险因素分析[J].中国临床新医学,2010,3(10):947-950.
[21]黄跃东,吴晓云.川崎病并发巨噬细胞活化综合征研究进展[J].现代医药卫生,2018,34(8):1187-1189.
[22]张艳艳,卢彦敏,李自普.川崎病并发巨噬细胞活化综合征(附3例报告并文献分析)[J].青岛大学医学院学报,2011,47(5):444-446,449.
[23]陈莉,王献民,蓝明平.川崎病并巨噬细胞活化综合征1例并文献复习[J].名医,2018,(4):69-70.
[24]焦莉平,沈颖,易著文.2011中国儿童血液净化论坛会议纪要[J].中国实用儿科杂志,2011,26(8):628-629.
[25]袁丽华,徐元芹,王岩艳,等.川崎病并巨噬细胞活化综合征3例报告并文献复习[J].青岛大学医学院学报,2012,48(6):544-545.
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