维生素D可能会影响PIMS-TS/MIS-C的疾病进程:一项观察性队列研究
James E G Charlesworth1,2, Joshua Navarajasegaran3, Akhila Kavirayani4
1Department of Paediatrics, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
概括
需要血管活性药物的儿童多系统炎症综合征 (PIMS-TS) 患者的NT-pro-BNP水平更高,住院时间更长. 维生素D水平与炎症标志物和治疗持续时间相关,而甲基prednisolone在没有冠状动脉瘤的情况下迅速降低了CRP.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 传染病 传染病 传染病
- 关键护理医学 关键护理医学
背景情况:
- 儿科多系统炎症综合征暂时与SARS-CoV-2 (PIMS-TS) 相关,与川崎病具有共同特征,但对生物标志物相关性了解甚少.
- 过渡性心脏功能障碍在PIMS-TS中很常见,因此需要更好地了解疾病严重性标志物.
研究的目的:
- 调查PIMS-TS.TS的儿科患者生物标志物,疾病严重程度和治疗结果之间的关系.
- 评估甲基普雷迪尼索隆在治疗PIMS-TS及其对炎症标志物的影响中的疗效.
主要方法:
- 在2020年5月至2022年5月期间接受治疗的63名PIMS-TS患者的回顾性评估.
- 需要血管活性药物的患者与不需要血管活性药物的患者的比较.
- 分析人口统计数据,临床特征,生化标志物 (包括NT-pro-BNP和维生素D),治疗方法和结果.
主要成果:
- 需要血管活性药物的患者表现出明显更高的NT-pro-BNP峰值和更长的住院时间.
- 较低的维生素D水平与较高的峰值C反应蛋白 (CRP) 和较长时间的血管活性药物使用相关.
- 与单独IVIg或没有免疫调节治疗相比,甲基普雷尼索隆治疗导致CRP的更快降低,没有观察到冠状动脉动脉瘤.
结论:
- 在PIMS-TS患者中,早期的甲基普雷迪尼索隆 (methylprednisolone) 管理有效地抑制了CRP,而不会引起冠状动脉瘤.
- 维生素D水平,SARS-CoV-2抗体标位,炎症生物标志物和PIMS-TS.中需要血管活性药物之间存在显著的关系.
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