JAHA:克拉霉素+静脉注射免疫球蛋白可以降低川崎病复发率

2017-07-07 xiangting MedSci原创

尽管IVIG +克拉霉素治疗不能缩短发热时间,但却降低了川崎病的复发率和缩短了住院时间。

以前报道过生物膜和先天免疫导致川崎病发病。这项研究旨在评估对川崎病患者使用克拉霉素(抗生物膜药物)的疗效。

研究人员在8家医院开展了一项开放标签,多中心,随机,2期试验。符合条件的患者包括4个月至5岁的儿童,他们在病程的第4至8天入组。参与者被随机分配接受静脉注射免疫球蛋白(IVIG)或IVIG加克拉霉素治疗。主要终点是IVIG治疗开始后发热持续时间。81名合格患者被随机分组。2组间发热时间均无统计学差异(平均值±SD:IVIG +克拉霉素组和IVIG组,34.3±32.4和31.1±31.1小时[ P = 0.66])。IVIG加克拉霉素组患者复发率明显低于IVIG组(12.5%vs 30.8%P = 0.046)。研究期间未发生严重不良事件。在事后分析中,IVIG加克拉霉素组的患者需要比IVIG组平均住院时间短(8.9天vs.10.3天,P = 0.049)。

尽管IVIG +克拉霉素治疗不能缩短发热时间,但却降低了川崎病的复发率和缩短了住院时间。

原始出处:

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    2018-03-01 xzw113
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    2017-10-21 fusion
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beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Jul 09 02:13:00 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283881, encodeId=761b128388141, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Jul 09 02:13:00 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492465, 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11:24:09 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219494, encodeId=e07321949425, content=好好的看看有进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jul 07 12:13:30 CST 2017, time=2017-07-07, status=1, ipAttribution=)]
    2017-07-29 李东泽

    很好,不错,以后会多学习

    0

  5. 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11:24:09 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219494, encodeId=e07321949425, content=好好的看看有进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jul 07 12:13:30 CST 2017, time=2017-07-07, status=1, ipAttribution=)]
    2017-07-25 李东泽

    很好,不错,以后会多学习

    0

  6. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sun Jul 09 02:13:00 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283881, encodeId=761b128388141, content=<a href='/topic/show?id=ce1b2908938' target=_blank style='color:#2F92EE;'>#免疫球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29089, encryptionId=ce1b2908938, topicName=免疫球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sun Jul 09 02:13:00 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492465, encodeId=c3b6149246585, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Jul 09 02:13:00 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219929, encodeId=a2a0219929df, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Jul 08 11:24:09 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219494, encodeId=e07321949425, content=好好的看看有进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jul 07 12:13:30 CST 2017, time=2017-07-07, status=1, ipAttribution=)]
    2017-07-09 zhaohui6731
  7. 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11:24:09 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219494, encodeId=e07321949425, content=好好的看看有进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jul 07 12:13:30 CST 2017, time=2017-07-07, status=1, ipAttribution=)]
  8. 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  9. [GetPortalCommentsPageByObjectIdResponse(id=2035146, encodeId=7aad203514609, content=<a href='/topic/show?id=5a426866eae' target=_blank style='color:#2F92EE;'>#球蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68667, encryptionId=5a426866eae, topicName=球蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2317301, createdName=xzw113, createdTime=Thu Mar 01 04:13:00 CST 2018, time=2018-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1922411, encodeId=98c81922411db, content=<a href='/topic/show?id=4a80425e534' target=_blank style='color:#2F92EE;'>#复发率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42575, encryptionId=4a80425e534, topicName=复发率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, 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encodeId=c3b6149246585, content=<a href='/topic/show?id=685199141a6' target=_blank style='color:#2F92EE;'>#静脉注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99141, encryptionId=685199141a6, topicName=静脉注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e28942453, createdName=millore, createdTime=Sun Jul 09 02:13:00 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219929, encodeId=a2a0219929df, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Jul 08 11:24:09 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219494, encodeId=e07321949425, content=好好的看看有进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Jul 07 12:13:30 CST 2017, time=2017-07-07, status=1, ipAttribution=)]
    2017-07-08 清风拂面

    学习了,谢谢分享

    0

  10. 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    2017-07-07 忠诚向上

    好好的看看有进步

    0

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Cardiology:川崎病相关的咽后淋巴结免疫细胞的不同分布

咽后的病变通常和川崎病相关(KD)。一个4岁大的男性刚开始呈现出扁桃体周围和咽后的脓肿病变。扁桃腺外科手术的治疗避免了纵隔脓肿的风险,但是他在手术后仍旧完成了KD诊断规则。这促使了研究人员对KD扁桃体进行组织学的研究。研究人员对KD扁桃体样品的组织学病理与从4名慢性扁桃体炎患者并且通过免疫染色确定与KD无关进行了比较。 研究发现,KD扁桃体炎在扁桃体周围肌肉层表现出小的淋巴滤泡和中性粒细

JAHA:miR-223参与了川崎病的血管损伤吗?

在川崎病患者中,血管内皮细胞中血细胞来源的miR-223水平显著升高。血管内皮细胞中增加的miR-223可以作为一个新的内分泌遗传信号,并且参与川崎病的血管损伤。miR-223可能为川崎病的血管并发症提供了一种新的机制和新的治疗靶点。

Circulation:川崎病的诊断、治疗和长期管理——AHA医疗卫生人员的科学声明

川崎病是一种儿童时期的急性血管炎,在约25%的未治疗病例中,可造成冠状动脉瘤。在发达国家,已经广泛对其报道,并且成为发达国家儿童获得性心脏病的主要原因。2017年4月,发表在《Circulation》的一项美国心脏病协会卫生专业人员的科学声明阐述了川崎病的诊断、治疗和长期管理。

强大总结:一文读懂川崎病!

川崎病是儿童时期常见的一种自身免疫性全身血管炎疾病,具有自限性,常发生于5岁以下儿童,其可累及中小血管,特别是冠状动脉,出现冠状动脉扩张、狭窄、动脉瘤以及心肌梗死等,未经正规治疗的患儿,其冠状动脉病变发生率为25%-30%,而及早接受治疗后,冠状动脉瘤的发生率可降低到5%[1] 。现对本人学习川崎病的资料进行总结,整理后与大家分享,抛砖引玉。对于冠脉的损害,学者们认为可能与血管内皮细胞损伤、血

小儿发热持续不退,很可能是“它”惹的祸!

导  语   3岁男孩持续发热6天,伴单侧急性非化脓性颈部淋巴结肿大(直径2cm),双眼球结膜充血、无分泌物,全身伴多形性红斑,这些症状竟然是川崎病惹的祸! 一、前言 川崎病(又称皮肤黏膜淋巴结综合征)目前已成为儿童时期最常见的获得性心血管疾病病因之一。好发于小年龄儿童,以全身血管炎为主要病变的急性热性疾病,部分患儿可侵犯冠状动脉。临床表现有发热、皮肤黏