临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (10): 736-.doi: 10.3969/j.issn.1000-3606.2021.10.005

• 心血管疾病专栏 • 上一篇    下一篇

川崎休克综合征致急性肾损伤1例报告

张海洋, 罗黎力, 李德渊, 乔莉娜   

  1. 四川大学华西第二医院儿童重症医学科 妇儿疾病与出生缺陷教育部重点实验室(四川成都 610041)
  • 出版日期:2021-10-15 发布日期:2021-09-28
  • 通讯作者: 张海洋 电子信箱:haiyang 0903 @hotmail.com
  • 基金资助:
    国家自然科学基金青年项目(No. 81701499)

Acute kidney injury caused by Kawasaki disease shock syndrome: a case report

ZHANG Haiyang, LUO Lili, LI Deyuan, QIAO Lina   

  1. Department of Pediatric Intensive Care Unit, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041 , Sichuan, China
  • Online:2021-10-15 Published:2021-09-28

摘要: 目的 探讨川崎休克综合征并发急性肾损伤的临床特征及治疗。方法 回顾分析1 例川崎休克综合征合 并急性肾损伤患儿的临床资料。结果 12岁女性患儿,因发热、呕吐起病,诊断脓毒性休克,逐渐出现急性肾损伤;患 儿于发热10天后热退,5次连续性肾脏替代治疗后尿量恢复,血压稳定,尿素氮和肌酐恢复正常。后期复查心脏彩超提 示冠脉扩张,修正诊断为川崎休克综合征,加用阿司匹林口服出院。长期随访心脏彩超示冠脉扩张消失。结论 川崎休 克综合征早期诊断需与脓毒性休克鉴别,一旦并发急性肾损伤,积极采用血液净化治疗可有效改善预后。

关键词: 川崎病; 急性肾损伤; 连续性肾脏替代治疗

Abstract: Objective To explore the clinical features and treatment of Kawasaki disease shock syndrome (KDSS) with acute kidney injury (AKI). Method The clinical data of KDSS with AKI in a child was reviewed and analyzed. Results A 12 -year-old girl presented with fever and vomiting at the onset of Kawasaki disease. Acute kidney injury developed gradually after septic shock was diagnosed. The fever subsided 10 days later, urine output recovered after 5 continuous renal replacement treatment (CRRT), and blood pressure stabilized. The urea nitrogen and creatinine returned to normal. Later re-examination of cardiac color Doppler echocardiography indicated coronary artery dilation, and then the diagnosis was revised as KDSS. The patient was treated with aspirin and discharged from the hospital. Long-term follow-up showed that the coronary dilatation disappeared. Conclusions KDSS should be diagnosed from septic shock at the early stage. Once AKI is complicated, the active use of CRRT can effectively improve the prognosis.

Key words: Kawasaki disease; acute kidney injury; continuous renal replacement treatment