炎症性心肌病20例临床分析

Clinical analysis of twenty cases of inflammatory cardiomyopathy

目的探讨炎症性心肌病的临床特点。方法收集20例炎症性心肌病患儿的病史、体格检查及随访资料,对比分析患儿治疗前后的心电图、胸部X片、超声心动图及心功能测定等变化。结果 20例炎症性心肌病患儿,发病年龄2岁3个月～11岁8个月,随访8个月～3年3个月。患儿在患病前1～4周均有感染史,临床表现为咳嗽、胸闷、气促和心音低钝,实验室检查主要为炎性指标升高,超声心动图示左房左室大、室壁运动幅度减低和左室射血分数降低,心电图示ST-T改变和期前收缩,胸部X线摄片为肺淤血和心脏扩大。经过治疗,临床痊愈2例,好转11例,2例病情无变化,死亡3例,失访2例。结论炎症性心肌病可发生于任何年龄,临床表现为急/慢性心功能不全,预后较好,部分可治愈。

Objective To explore the clinical features of inflammatory cardiomyopathy. Methods The detailed history, physical examination, and follow-up data in 20 children with inflammatory cardiomyopathy were examined. Comparison was made with electrocardiogram, X-ray, echocardiography and cardiac function before and after treatments. Results The age at onset ranged from 2.25 to 11.67 years in 20 children with inflammatory cardiomyopathy. They all had a history of 1 - 4 weeks of infection. Clinical symptoms included cough, chest distress, and polypnea, the examina- tion revealed cardiac enlargement, reduced left ventricular ejection fraction and elevated laboratory inflammatory markers. After treatment, 2 children recovered, 11 improued 2 had no changes, 3 died of heart failure, and 2 lost. The clinical cure rate was 10%, the improvement rate was 55%, and the mortality was 15%. Conclusions The inflammatory cardiomyopathy occurs at any age, and manifests symptoms of acute/chronic heart failure in clinic. With comprehensive treatments, natients had satisfactory nro^nosis and some recovered completely.