儿童心肌病心力衰竭恶化的识别和处理

Identification and treatment of worsening heart failure in children with cardiomyopathy

心肌病是一组高度异质性的心肌疾病,反复发生的心力衰竭恶化(简称心衰恶化)是导致心肌病患儿高住院率及高致死率的主要原因,且使心肌病患儿更快地进入终末期。心衰恶化概念的描述首见于儿科心衰研究文献,但遗憾的是,近50余年来罕有儿童心衰恶化的临床研究。本文参考成人当前的心衰恶化定义并结合儿童心衰的特点,对儿童心肌病心衰恶化的概念、诱因和危险因素、识别及处理做一简述。

Cardiomyopathy is a group of highly heterogeneous myocardial diseases.Recurrent worsening heart failure(WHF)is the main reason for the high hospitalization rate and high mortality rate in children with cardiomyopathy,and makes children rapidly enter the end-stage of heart failure.The concept of WHF was first described in the literature on pediatric heart failure.Unfortunately,clinical studies of WHF in children during the past five decades are rare.Based on the current definition of adult WHF and the characteristics of pediatric heart failure,this review briefly introduced the concept,inducement and risk factors,identification and management of WHF in children with cardiomyopathy.