与川崎病相比,MIS-C儿童的中期心血管结果:一个多中心前性队列研究
Sappaya Khrongsrattha1, Chodchanok Vijarnsorn2, Kanokvalee Santimahakullert3
1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Scientific reports
|November 29, 2025
概括
儿童多系统炎症综合征 (MIS-C) 导致暂时的心脏功能障碍,而川崎病 (KD) 导致儿童中期冠状动脉异常. 这两种情况都显示了心脏功能的恢复,但KD有更持久的冠状动脉问题.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 传染性疾病 传染性疾病
- 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) 和川崎病 (KD) 分享重叠的症状,引发了对长期心血管影响的担忧.
- 了解MIS-C和KD幸存者的中期心血管后果对于患者管理至关重要.
研究的目的:
- 为了前性地比较MIS-C和KD幸存下来的儿童的中期心血管结果.
- 为了评估MIS-C和KD幸存者之间的左心室功能和冠状动脉异常之间的差异,诊断后1-3年.
主要方法:
- 一项多中心前性队列研究,涉及122名儿童 (66名MIS-C,56名KD) 进行心声回声监测.
- 在诊断后1-3年评估左心室喷射分数 (LVEF),冠状动脉异常和左心室全球纵向应变 (LVGLS).
- 在MIS-C和KD组之间比较基线特征和中期结果.
主要成果:
- 在诊断时,MIS-C患者的年龄较大,与KD (0%) 相比,最初的左心室功能障碍 (25.8%) 更常见.
- 所有患者在随访后恢复了正常的LVEF,但一名MIS-C患者表现出持续的亚临床损伤 (异常LVGLS).
- 冠状动脉异常在MIS-C显著下降 (30%至1.5%),但在随访时仍然在KD (14.2%) 较高,包括脱血和动脉瘤.
结论:
- MIS-C与过渡性心室功能障碍相关,但罕见的持续性冠状动脉干扰.
- 川崎病带有较高的中期冠状动脉异常负担,尽管心脏功能和LVGLS得以保留.
- 对于MIS-C和KD的幸存者来说,长期的心血管监测是必不可少的,重点是KD患者的冠状动脉健康.
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