川崎病休克综合征伴多种心血管并发症及多系统功能损伤1例

目的 提高对川崎病休克综合征（KDSS）的早期识别及对川崎病心脏损害多样性的认识，并加强个体化管理。方法报道1例川崎病病儿伴KDSS、心肌炎、瓣膜病变、急性心力衰竭、心律失常、冠状动脉瘤及高凝状态、肝功能不全、急性肾损伤等多系统功能损伤的病例，并以“川崎病”“川崎病休克综合征”“冠状动脉瘤”（包括中英文）为关键词或主题词对PubMed和中国知网中截至2020年12月收录的论文进行检索，收集并分析检索到的病人的资料。结果 该例川崎病病儿临床诊断明确，起病即出现KDSS且伴有多系统功能受损，病情危重，临床处理存在矛盾。经治疗病儿生命体征平稳，但在亚急性期出现中型冠状动脉瘤。检索文献共收集到8篇相关病例报道，发现近些年KDSS的报道逐渐增多，然而同时合并多种心血管并发症及多系统功能损伤的病例仍较少见。结论 川崎病除了有我们熟知的典型并发症冠状动脉病变，还可在疾病发生发展过程中并发多种心脏损害，尤其需加强对出现血流动力学不稳定的KDSS进行早期识别和诊治。

Kawasaki disease shock syndrome with multiple cardiovascular complications and multiple system dysfunction: a case report

Objective To improve the early recognition of Kawasaki Disease Shock Syndrome (KDSS) and the understanding of thediversity of heart damage in Kawasaki Disease, and to strengthen individualized management.Methods A case of Kawasaki disease with KDSS, myocarditis, valvular disease, acute heart failure, arrhythmia, coronary aneurysm, and multiple system dysfunction (such ashypercoagulable state, liver insufficiency, acute kidney injury) was reported. "Kawasaki disease", "Kawasaki disease shock syndrome","coronary artery aneurysm " (including Chinese and English) were used as keywords or subject terms to search PubMed and CNKI, asof December 2020, the retrieved patient data were collected and analyzed.Results This case of Kawasaki disease had KDSS at the on. set of the disease, and was accompanied by multiple systemic dysfunctions. The condition was critical and the clinical management wascontradictory. After treatment, the life of the child was stable, but a medium-sized coronary aneurysm appeared in the subacute stage. Atotal of 8 relevant case reports were collected from the searched literature, and it was found that reports of KDSS gradually increased inrecent years. However, it was still relatively rare to have multiple cardiovascular complications and multiple system functional impair.ments at the same time.Conclusion In addition to the well-known typical complications of coronary artery disease, Kawasaki diseasecan also be complicated by a variety of heart damages during the development of the disease. In particular, it is necessary to strengthenthe early identification, diagnosis and treatment of KDSS with hemodynamic instability.