摘要: |
[摘要]目的:探讨儿童暴发性心肌炎(FM)的预后并分析影响儿童FM预后的危险因素。方法:回顾性分析2014-2020年湖南省儿童医院确诊的FM患儿临床资料。根据患儿住院期间及随访的生存状态分为存活组及死亡组,收集患儿一般资料、临床症状及相关实验室指标,并进行随访。筛选影响预后的相关因素进行单因素分析及多因素Logistic回归分析。结果:共收集61例FM患儿,有病原学感染依据30例(49.2%),以呼吸道病毒及肠道病毒为主。以消化道症状起病24例(39.3%)、呼吸道症状起病19例(31.1%)、神经系统症状起病7例(11.5%)、循环系统症状起病11例(18.0%)。存活组共52例(85.2%),包括心功能减退及心脏扩大7例(11.5%)。死亡组共9例(14.8%)。存活组心律失常以三度房室传导阻滞为主,死亡组以室性心动过速为主,单因素分析结果显示起病时间、住院时间、肌酸激酶(CK)、激酸激酶同工酶(CK-MB)、超敏肌钙蛋白是可能影响FM患儿预后的因素,多因素Logistic回归分析显示起病时间、超敏肌钙蛋白差异有统计学意义。结论:FM起病时间越短,超敏肌钙蛋白水平越高,预后可能越差。 |
关键词: 暴发性心肌炎 危险因素 预后 |
DOI:doi:10.13407/j.cnki.jpp.1672-108X.2022.10.009 |
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基金项目:儿童急救医学湖南省重点实验室项目,编号2018TP1028。 |
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Analysis of Risk Factors Affecting the Prognosis of Fulminant Myocarditis in Children |
Wang Dan, Xiao Yunbin, Xiao Zhenghui, Chen Zhi, Wang Yefeng, Wang Xun, Xiang Jinxing |
(Academy of Pediatrics, University of South China, Hunan Children’s Hospital, Changsha 410007, China) |
Abstract: |
[Abstract] Objective: To explore the prognosis of children with explosive myocarditis (FM) and analyze the risk factors affecting the prognosis of FM. Methods: Clinical data of children diagnosed with FM in Hunan Children’s Hospital from 2014 to 2020 were retrospectively analyzed. According to the survival status during hospitalization and follow-up, all children were divided into the survival group and the death group. The general data, clinical symptoms and related laboratory indicators were collected and followed up. The relevant factors affecting prognosis were screened for univariate analysis and multivariate Logistic regression analysis. Results: A total of 61 children with FM were collected, and there were 30 cases (49.2%) with pathogenic infections based on respiratory and enteroviruses. Totally 24 cases (39.3%) were onset with gastrointestinal symptoms, 19 cases (31.3%) with respiratory symptoms, 7 cases (11.5%) with neurological symptoms, and 11 cases (18.0%) with circulatory system symptoms. There were 52 cases (85.2%) in the survival group, including 7 cases (11.5%) with hypocardiac function and heart enlargement, and 9 cases (14.8%) in the death group. The main arrhythmia in the survival group was third-degree atrioventricular block, and the main arrhythmia in the death group was ventricular tachycardia. Univariate analysis showed that onset time, length of stay, creatine kinase (CK), kinase isoenzyme (CK-MB), and high-sensitivity troponin were factors that may affect the prognosis of children with FM. Multivariate Logistic regression analysis showed that there were significant differences in the onset time and high-sensitivity troponin. Conclusion: The shorter the onset time of FM and the higher the high-sensitivity troponin, the worse the prognosis may be. |
Key words: fulminant myocarditis risk factors prognosis |