儿童多系统炎症综合征的早期治疗
Brian Jonat1, Andrew S Geneslaw1, Christine A Capone2
1Department of Pediatrics, Columbia University Irving Medical Center, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York.
Pediatrics
|August 3, 2023
概括
早期使用葡萄糖皮质激素和IVIG治疗显著缩短了MIS-C儿童住院的时间. 这种组合疗法推给住院的MIS-C患者,以减少住院时间.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染病 传染病 传染病
- 免疫学 免疫学 免疫学
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 是SARS-CoV-2感染后的一种严重的过度炎症状况.
- 最佳的MIS-C治疗方法尚不清楚,尽管IVIG和葡萄皮糖类药物显示出有前途.
- 早期的葡萄糖皮质激素治疗被假设可以减少住院时间 (LOS).
研究的目的:
- 研究MIS-C患者早期葡萄糖皮质激素治疗和医院LOS之间的关联.
- 评估早期葡萄糖皮质激素对重症监护室 (ICU) LOS的影响.
- 为了确定IVIG和葡萄糖皮质激素的早期联合治疗是否改善了结果.
主要方法:
- 在131名MIS-C患者的多中心回顾性队列研究中.
- 主要结局:医院LOS,比较在入院48小时内接受葡萄糖皮质类药物治疗的患者与没有接受葡萄糖皮质类药物的患者.
- 二次结果:ICU LOS;进行了未调整和调整的分析.
主要成果:
- 早期使用葡萄糖皮质醇与较高的早期IVIG和ICU入院率有关.
- 早期的葡萄糖皮质类药物与更短的ICU LOS (4 vs. 9天,P = .004) 有关.
- 经过调整后的分析显示,早期的皮质糖类药物 (IRR 0.75,P = .025) 和早期的IVIG (IRR 0.56,P = .026) 独立地缩短了医院LOS.
结论:
- 早期服用葡萄糖皮质类药物和IVIG独立地与MIS-C患者的医院LOS减少有关.
- 这项研究支持对住院MIS-C儿童进行IVIG和葡萄糖皮质激素的早期联合治疗.
- 需要进一步的研究来确定最佳剂量和治疗持续时间.
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