目的 探讨儿童多系统炎症综合征(multisystem inflammatory syndrome in children,MIS-C)的临床特征及诊治要点。方法 回顾性分析西安交通大学附属儿童医院风湿免疫科收治的2例MIS-C患儿相关临床资料,并复习相关文献。结果 2例患儿男女各1例,男性患儿2岁1月龄,女性患儿3岁8月龄,发病4周前均有新型冠状病毒感染史,病初以川崎病样症状为主要临床表现,病程中累及消化、循环、血液、呼吸等多个系统,其中1例累及神经系统;并结合实验室检查最终诊断MIS-C。2例患儿均接受静脉注射人免疫球蛋白及糖皮质激素治疗,其中1例因病情进展行连续性血液净化及无创呼吸机辅助通气治疗,预后均良好。结论 对于近期有新型冠状病毒感染,出现类似川崎病症状,则应考虑MIS-C的可能,该疾病进展快且易并发多系统受累,需早识别、早干预,以改善预后。

Objective To explore the clinical features and key points of diagnosis and treatment of multisystem inflammatory syndrome in children (MIS-C). Methods The clinical data of two children with MIS-C diagnosed and treated in the Department of Rheumatology and Immunology of XJTU Affiliated Children's Hospital were retrospectively analyzed and the relevant literature was reviewed. Results There were two patients (1 male and 1 female), the age of male was 2 years and 1 month, and the age of female was 3 years and 8 months. Both had a history of SARS-CoV-2 infection 4 weeks before their illness onset. At the beginning of the disease, Kawasaki Disease-like symptoms were the main clinical manifestations, with multi-system involvement in the course of the disease, including prominent gastrointestinal, cardiac, hematologic and respiratory, and one of them with neurologic symptoms. MIS-C was finally diagnosed according to the results of laboratory examination. All of them were treated with intravenous immunoglobulin and glucocorticoids. One of them was treated with continuous kidney replacement therapy and noninvasive mechanical ventilation due to progressive disease, and both patients had a good prognosis. Conclusion MIS-C should be considered in patients with recent SARS-CoV-2 infection followed by Kawasaki disease-like symptoms. The disease progresses rapidly and involves multiple systems, so early recognition and intervention are needed to improve the prognosis.