全身炎症反应综合征在婴幼儿肺炎合并心衰中的表现

Clinical significance of systemic inflammatory response syndrome following pneumonia complicated by actue congestive heart failure in infants

目的 应用新概念──全身炎症反应综合征（ＳＩＲＳ）评估婴幼儿肺炎合并心衰的病程及预后。方法 总结３２例婴幼儿肺炎合并心衰者，根据Ｈａｙｄｅｎ修订的ＳＩＲＳ诊断标准进行临床分析。结果 婴幼儿肺炎合并心衰３２例，符合ＳＩＲＳ诊断标准者共２７例，与ＳＩＲＳ≤２ｄ相比，ＳＩＲＳ≥ｄ者其心衰持续时间轻长，预后也差。患儿入院危重评分＜９０分，或伴有其他合并症，是ＳＩＲＳ≥３ｄ的高危因素。患儿月龄、性别和ＳＩＲＳ项目与ＳＩＲＳ持续时间无明显相关。ＳＩＲＳ持续时间与心衰持续时间呈明显相关。结论ＳＩＲＳ持续时间是婴幼儿肺炎合并心衰病情评估的有用指标，ＳＩＲＳ的持续存在，将影响患儿心衰症状的改善。应予以重视和早期干预。

Objective To employ the new concept of systemic inflammatory response syndrome (SIRS) to evaluate the course and outcome of illness in pneumonia complicated by acute congestive heart failure in infants. Methods Accord-ing to the criteria of SIRS by Hayden, thirty - two infants with pneumonia complicated by acute congestive heart failure were studied. Results Twenty seven cases (27/32) were diagnosed as SIRS. The duration of heart failure was significantly longer in patients with SIRS for ≥3 days than that of SRIS sustained for ≤2 days. The former had a outcome. The risk of factors of SIRS for ≥ 3 days included other complications and severity of the illness. The duration of SIRS was not related to the age, sex and the number of SIRS criteria, but was correlated with heart failure. Conclusion The duration of SIRS may be used to evaluate the infants with pneumonia complicated by acute congestive heart failure. Persistent SIRS may hamper the amelioration of heart failure and early intervention should be taken in such cases.