儿童多系统炎症综合征中的参与:不仅是急性损伤
Alessandra Meneghel1, Valentina Masenello1, Fiorenza Alfier1
1Pediatric Rheumatology Unit, Department for Woman and Child's Health, University of Padua, 35128 Padua, Italy.
Children (Basel, Switzerland)
|October 28, 2023
概括
脏问题,包括急性脏损伤和管状功能障碍,影响了超过三分之一的SARS-CoV-2多系统炎症综合征 (MIS-C) 的儿童. 这些脏问题与密集护理需求增加和炎症相关.
科学领域:
- 儿科脏病学 儿科脏病学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 是一种罕见但严重的疾病,与SARS-CoV-2有关.
- 在MIS-C中脏的参与仍未得到充分研究,因此需要对其频谱和影响进行进一步的研究.
研究的目的:
- 在被诊断为MIS-C的儿科患者中描述脏干扰的范围.
- 分析与MIS-C功能障碍相关的临床和实验室特征.
- 探索损伤对重症监护要求和患者结果的影响.
主要方法:
- 在一个单一的中心进行了一项回顾性观察研究.
- 分析了2020年4月至2022年5月期间诊断的55名MIS-C患者的数据.
- 人口,临床,儿科重症监护室 (PICU) 的入院数据和实验室标记在呈现和6个月后续收集.
主要成果:
- 在36.4%的MIS-C患者 (20/55) 中发现了脏干扰,包括13例急性脏损伤 (AKI),7例隔离管管功能障碍 (TD) 和8例联合AKI-TD.
- 患有AKI的患者需要显著更高水平的重症监护,包括PICU入院 (61.5%),异型药物 (46.2%) 和二线免疫疗法 (53.8%).
- AKI与较低的二碳酸盐水平和升高的炎症标志物 (PCT,IL-6) 相关,而与AKI-TD相比,孤立的TD显示出较高的二碳酸盐和较低的炎症.
结论:
- 在MIS-C中,损伤似乎是前因素和炎症过程的结合造成的.
- 这项研究确定了管状功能障碍是MIS-C脏参与的明显表现.
- 这些发现为评估和管理MIS-C儿童并发症提供了新的见解.
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