新型冠状病毒感染相关儿童多系统炎症综合征与细胞因子风暴

COVID-19 infection-associated multisystem inflammatory syndrome and cytokine storms in children

儿童多系统炎症综合征(MIS-C)是一种合并多器官功能受损的全身炎症综合征,大多数患儿存在新型冠状病毒(SARS-CoV-2)感染证据或新型冠状病毒肺炎(COVID-19)患者接触史。患儿常出现发热、胃肠道症状、心功能异常及休克等表现。细胞因子风暴(CS)是由外界刺激触发的全身性炎症反应,引起CS的诱因包括医源性、病源性、单基因或自身免疫性疾病等。MIS-C发病机制尚未完全明确,可能与SARS-CoV-2感染后引起的机体过度免疫反应有关。就COVID-19感染相关MIS-C的临床特征和CS的发生及诱因予以综述,并讨论两者间的关系,以期为MIS-C的机制研究和临床诊断提供参考。

Multisystem inflammatory syndrome in children(MIS-C) is a systemic inflammatory syndrome with multiorgan dysfunctions.Most of the children have evidence of severe acute respiratory syndrome-associated coronavirus(SARSCoV-2) infection or a history of exposure to patients with coronavirus disease 2019(COVID-19).Children often present with fever,gastrointestinal symptoms,cardiac dysfunctions,shock and other multi-system symptoms.Cytokine storm(CS) is an inflammatory response triggered by external stimulations.Factors causing CS include iatrogenic,pathogenic,monogenic or autoimmune diseases.The pathogenesis of MIS-C is still unclear,which may be related to the over-response of immune system caused by SARS-CoV-2 infections.In this paper,the clinical characteristics of COVID-19 infection-related MIS-C are summarized,and the relationship between MIS-C and CS is discussed,aiming to provide references for the mechanistic investigation and clinical diagnosis of MIS-C.