[Clinical research of multisystem inflammatory syndrome in children].

Objective: To analyze the clinical characteristics of children with multisystem inflammatory syndrome (MIS-C) associated with SARS-CoV-2 in China, and to improve the understanding of MIS-C among pediatricians. Methods: Case series study.Collect the clinical characteristics, auxiliary examinations, treatment decisions, and prognosis of 64 patients with MIS-C from 9 hospitals in China from December 2022 to June 2023. Results: Among the 64 MIS-C patients, 36 were boys and 28 were girls, with an onset age being 2.8 (0.3, 14.0) years. All patients suffered from fever, elevated inflammatory indicators, and multiple system involvement. Forty-three patients (67%) were involved in more than 3 systems simultaneously, including skin mucosa 60 cases (94%), blood system 52 cases (89%), circulatory system 54 cases (84%), digestive system 48 cases (75%), and nervous system 24 cases (37%). Common mucocutaneous lesions included rash 54 cases (84%) and conjunctival congestion and (or) lip flushing 45 cases (70%). Hematological abnormalities consisted of coagulation dysfunction 48 cases (75%), thrombocytopenia 9 cases (14%), and lymphopenia 8 cases (13%). Cardiovascular lesions mainly affected cardiac function, of which 11 patients (17%) were accompanied by hypotension or shock, and 7 patients (12%) had coronary artery dilatation.Thirty-six patients (56%) had gastrointestinal symptoms, 23 patients (36%) had neurological symptoms. Forty-five patients (70%) received the initial treatment of intravenous immunoglobulin in combination with glucocorticoids, 5 patients (8%) received the methylprednisolone pulse therapy and 2 patients (3%) treated with biological agents, 7 patients with coronary artery dilation all returned to normal within 6 months. Conclusions: MIS-C patients are mainly characterized by fever, high inflammatory response, and multiple organ damage. The preferred initial treatment is intravenous immunoglobulin combined with glucocorticoids. All patients have a good prognosis.目的： 分析新型冠状病毒感染相关儿童多系统炎症综合征（MIS-C）的临床特征，提高临床医生对MIS-C的认识。 方法： 病例系列研究。纳入2022年12月至2023年6月全国9家医院收治的64例MIS-C患儿为研究对象，对患儿临床特征、辅助检查、治疗决策及预后资料进行回顾和描述性分析。 结果： 64例MIS-C患儿中男36例、女28例，发病年龄2.8（0.3，14.0）岁。所有患儿均有发热、炎症指标升高及多系统受累表现。43例（67%）患儿同时累及3个系统以上，其中皮肤黏膜60例（94%）、血液系统52例（89%）、循环系统54例（84%）、消化系统48例（75%）以及神经系统24例（37%）等。皮肤黏膜损伤包括皮疹54例（84%）、结膜充血和（或）唇潮红45例（70%）；血液系统受累常见凝血功能异常48例（75%）、血小板减少症9例（14%）、淋巴细胞减少8例（13%）；心血管损伤主要影响心脏功能，其中合并低血压或休克11例（17%），合并冠状动脉扩张7例（12%）；36例（56%）患儿出现消化系统症状，23例（36%）患儿合并神经系统症状。45例（70%）患儿采用免疫球蛋白联合糖皮质激素治疗，5例（8%）给予糖皮质激素冲击、2例（3%）加用生物制剂，7例冠状动脉扩张患儿均在6个月内恢复正常。 结论： MIS-C患儿以发热、高炎症反应及多器官损伤为主要特征，免疫球蛋白联合糖皮质激素是一线治疗手段，难治性患儿可用激素冲击和生物制剂治疗，总体预后良好。.