儿童心肌炎112例临床分析

Clinical analysis of 112 cases of children with myocarditis

心肌炎(MC)是儿童时期引起心脏损害的常见原因之一。本文回顾性分析112例心肌炎患儿的临床资料,其中男65例,女47例;急性心肌炎90例,暴发性心肌炎22例;暴发性心肌炎组肌酸激酶(CK)、心型肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)等指标较急性心肌炎组增高(P均<0.05);90例急性心肌炎经积极治疗3~4周后均好转出院;22例暴发性心肌炎中13例治愈,8例死亡,1例自动出院。儿童心肌炎的临床表现不典型,需综合临床资料及心肌受损的指标以明确诊断。普通病例预后良好;暴发性心肌炎死亡率较高。

Myocarditis is a common reason of childhood to causemyocardial damage. The clinical data of 112 children with myocarditis were analyzed retrospectively 65 males and 47 females. There were 90 cases of acute myocarditis,22 cases of fulminant myocarditis. The levels ofcreatine kinase（CK）,MB isoenzyme of creatine kinase（CK-MB）,lactate dehydrogenase（LDH） and aspartate aminotransferase（AST） in fulminant myocarditis group were higher than those in acute myocarditis group（all P〈0.05）. 90 cases of acute myocarditis recovered after 3 ~ 4 weeks of treatment. Among the 22 cases of fulminant myocarditis,13 cases were cured,8 cases died and one was discharged automatically. The clinical manifestations of the children with myocarditis are atypical,and the comprehensive clinical data and the index of myocardial injury are needed to make a definite diagnosis. The prognosis of the mild cases is good. The fulminant myocarditis still has a high mortality rate.