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目的探讨疑似病毒性心肌炎患儿频发房性期前收缩的特点及近期预后。方法收集郑州大学第一附属医院儿科10年来收治的以频发房性期前收缩为主要临床表现的41例疑似病毒性心肌炎患儿临床资料,回顾性分析其动态心电图特点及房性期前收缩的近期预后,并探讨两者的关系。结果 (1)30例(73%)全天房性期前收缩总数小于20000,4例(10%)为房性并行心律,35例(85%)心房异位P’波可提前至T波,14例(32%)合并房性心动过速,多数病例为单源性期前收缩、起源于心房下部。(2)给予2周抗病毒、营养心肌、抗氧化及中成药治疗后,半数患儿房性期前收缩减少超过30%。(3)合并房性心动过速者比单纯频发房性期前收缩者近期预后好(P<0.05)。结论疑似病毒性心肌炎儿童的频发房性期前收缩,尤其是合并房性心动过速者,多为病毒性心肌炎引起,按病毒性心肌炎治疗可使期前收缩减少或消失。
Objective To investigate the characteristics and recent prognosis of children with suspected viral myocarditis with frequent atrial contraction. Methods The clinical data of 41 children with suspected viral myocarditis who were admitted to the First Affiliated Hospital of Zhengzhou University in the past 10 years and whose main clinical manifestations were frequent atrial contractions were collected. The characteristics of the dynamic electrocardiogram and the premature atrial contraction were retrospectively analyzed. The recent prognosis, and explore the relationship between the two. Results (1) Thirty patients (73%) had atrial premature systolic total of less than 20000 in 4 days (10%) and atrial arrhythmias in 35 patients (85%). Atrial ectopic P wave could be advanced to T wave , 14 cases (32%) with atrial tachycardia, the majority of cases of monogenic contraction, originated in the lower part of the atrium. (2) given 2 weeks antiviral, nourishing the myocardium, anti-oxidation and proprietary Chinese medicine treatment, half of the children atrial contraction reduced by more than 30%. (3) Patients with atrial tachycardia had a better prognosis than those with atrial systole only (P <0.05). Conclusion Suspected viral myocarditis in children with frequent atrial contraction, especially in patients with atrial tachycardia, mostly caused by viral myocarditis, viral myocarditis treatment can reduce or disappear before the contraction.