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目的探讨小儿病毒性心肌炎(VMC)的临床特点和治疗方法,为今后VMC的诊断和治疗提供临床依据。方法回顾性分析2007年1月—2010年1月收治的158例VMC患者的临床资料。结果本组158例VMC患者中婴儿组和幼儿组发病居多,各占38.0%和24.7%;发病季节以夏季为主,占40.5%;92.4%的患者有呼吸道感染史;临床症状主要表现为心前区不适、胸闷胸痛、长叹气和周身乏力等;胸片检查心胸比增大者21例,占13.3%;心脏超声检查异常7例;ECG阳性108例,占68.35%,HOLTER检查的47例患者中33例阳性,占70.21%;肌酸激酶(CK)升高25例,占15.8%;心肌酶(CK-MB)升高138例;乳酸脱氢酶(LDH)升高96例;谷草转氨酶(AST)升高58例;-羟丁酸(HBDH)升高41例;氨基末端脑利钠肽前体(NT-proBNP)升高67例;柯萨奇B组病毒(CVB)抗体阳性101例,占63.9%;本组病例均采用综合治疗措施后痊愈出院。结论 VMC的临床表现呈现多样性,婴幼儿和夏季多发;Holter检查有利于该病早期诊断;综合治疗疗效显著。
Objective To investigate the clinical features and treatment of pediatric viral myocarditis (VMC) and provide a clinical basis for the diagnosis and treatment of VMC in the future. Methods The clinical data of 158 patients with VMC admitted from January 2007 to January 2010 were retrospectively analyzed. Results The 158 cases of VMC in this group were mostly infants and young children, accounting for 38.0% and 24.7% respectively; the onset season was mainly in summer, accounting for 40.5%; 92.4% patients had respiratory tract infection; the clinical symptoms were mainly heart Chest discomfort, chest tightness, chest pain, long sighs and whole body fatigue; chest X-ray examination increased 21 cases, accounting for 13.3%; 7 cases of abnormal heart ultrasound examination; ECG positive 108 cases, accounting for 68.35%, HOLTER examination of 47 cases 33 cases were positive, accounting for 70.21%; creatine kinase (CK) increased 25 cases, accounting for 15.8%; elevated CK-MB 138 cases; lactate dehydrogenase (LDH) increased 96 cases; Elevated aminotransferases (AST) were found in 58 patients; elevated hydroxybutyrate (HBDH) was found in 41 patients; amino-terminal pro-brain natriuretic peptide (NT-proBNP) was increased in 67 patients; positive for coxsackie virus B (CVB) 101 cases, accounting for 63.9%; patients in this group were treated with comprehensive treatment was cured and discharged. Conclusions The clinical manifestations of VMC are diverse, infants and young children are more frequent in summer. Holter examination is helpful for the early diagnosis of the disease. The curative effect of comprehensive therapy is remarkable.