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

摘要

川崎病是一种急性儿童血管炎性疾病,目前已经成为发达国家儿童获得性心脏病最常见病因,其发病率有逐年上升趋势.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》提供了川崎病潜在病理变化的新证据,指出川崎病的诊断目前仍无特异性的诊断试验,为排他性诊断.2017版简化了不完全川崎病的诊断流程,进一步完善了对免疫球蛋白无反应和冠状动脉病变高风险患儿的初始治疗方案,强调了川崎病冠状动脉并发症以Z值评估并分类,川崎病的远期管理方案更加规范化.%Kawasaki disease (KD) is an acute vasculitis of childhood,which is the leading cause of acquired heart disease in children in developed countries.Its annual incidence has been increasing year by year.The 2017 edition of Diagnosis,Treatment,and Long-term Management of Kawasaki Disease:A Scientific Statement for Health Professionals from the American Heart Association has identified new evidence of pathological processes.The diagnosis of KD is based on the non-specific clinical pictures.Evaluation of suspected incomplete KD is simplified.Patients believed to be at high risk for IVIG-resistance and development of coronary,artery aneurysms may benefit from an improved primary adjunctive therapy.Z value is used to evaluate and classify the coronary artery,complications of KD.The long-term management of KD becomes more standardized.