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

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。

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

Multisystem inflammatory syndrome in children (MIS-C) is a systemic inflammatory syndrome with multi-organ dysfunctions. Most of the children have evidence of severe acute respiratory syndrome-associated coronavirus (SARS-CoV-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.