Acute viral myocarditis is an extremely diverse disease with a predictable good outcome with supportive therapy. The objective of this study was to look at the clinical outcome of patients receiving additional intrave...Acute viral myocarditis is an extremely diverse disease with a predictable good outcome with supportive therapy. The objective of this study was to look at the clinical outcome of patients receiving additional intravenous gamma globulin compared to those receiving conventional anti-congestive therapy alone. Patients and methods: This is a retrospective review of charts of children admitted with acute myocarditis. Group 1 was children who received intravenous gamma globulin (IVIG) along with conventional anti-congestive therapy. Group 2 were patients who received the conventional anticongestive therapy alone. Short-term outcome was survival to hospital discharge, and mid-term outcome was improvement of left ventricular ejection fraction at 6 months and one year follow-up. Results: A total of 36 patients were enrolled and 18 were males. The mean age of all patients was 2.3 ± 2.6 years and the mean duration of illness for the whole group was 6.7 ± 3.8 days. Group 1 comprised of 16 patients. There was no difference in short-term outcome with mortality of 2 patients in Group1 (12.5%) and 3(15%) in Group 2 (p = 0.2). At intermediate term follow up, recovery of ejection fraction in Group 1 was in 4/14 (28%) and in Group 2 it was 9/17 (55%) and at 12 months it was 10/13 (77%) in Group 1 and 15/16 (94%) in Group 2 (p = 0.02 and 0.19 respectively). Conclusion: Acute myocarditis has a high spontaneous cure rate. Our study did not show any significant difference in the short-term or midterm outcome between children receiving IVIG compared to those who did not.展开更多
目的:探讨丙种球蛋白无反应及敏感川崎病患儿血小板(PLT)、干扰素-γ(IFN-γ)、白介素-6(IL-6)表达水平的差异及临床意义。方法:选取2019年5月至2022年6月厦门大学附属中山医院收治的99例川崎病患儿,根据丙种球蛋白治疗反应性分为无反应...目的:探讨丙种球蛋白无反应及敏感川崎病患儿血小板(PLT)、干扰素-γ(IFN-γ)、白介素-6(IL-6)表达水平的差异及临床意义。方法:选取2019年5月至2022年6月厦门大学附属中山医院收治的99例川崎病患儿,根据丙种球蛋白治疗反应性分为无反应组24例和敏感组75例,比较两组基线水平及12 h、36 h PLT、IFN-γ、IL-6表达水平。采用Logistic回归分析川崎病丙种球蛋白无反应的相关影响因素,采用受试者工作特征曲线(ROC)分析PLT、IFN-γ、IL-6及联合预测川崎病丙种球蛋白无反应的价值,采用DeLong检验不同方案的预测价值,采用临床决策曲线分析法(DCA)分析PLT+IFN-γ+IL-6方案预测川崎病丙种球蛋白反应性的临床效用。结果:无反应组12 h及36 h PLT、IFN-γ、IL-6表达水平与基线水平比较,差异无统计学意义(P>0.05);敏感组12 h及36 h PLT、IFN-γ、IL-6表达水平均低于基线水平(P<0.05);无反应组基线水平及12 h、36 h PLT、IFN-γ、IL-6表达水平高于敏感组(P<0.05);基线PLT、IFN-γ、IL-6均为川崎病丙种球蛋白无反应的独立相关影响因素(P<0.05);PLT、IFN-γ、IL-6及联合的ROC曲线下面积(AUC)依次为0.818、0.767、0.712、0.915,PLT+IFN-γ+IL-6的AUC高于IFN-γ、IL-6(P<0.05),与PLT比较,差异无统计学意义(P>0.05);采用PLT+IFN-γ+IL-6方案预测川崎病丙种球蛋白无反应具有临床正向的净获益。结论:川崎病丙种球蛋白无反应和敏感患儿PLT、IFN-γ、IL-6表达水平存在显著差异,与患儿治疗反应性有关,联合检测PLT、IFN-γ、IL-6可预测丙种球蛋白治疗反应。展开更多
文摘Acute viral myocarditis is an extremely diverse disease with a predictable good outcome with supportive therapy. The objective of this study was to look at the clinical outcome of patients receiving additional intravenous gamma globulin compared to those receiving conventional anti-congestive therapy alone. Patients and methods: This is a retrospective review of charts of children admitted with acute myocarditis. Group 1 was children who received intravenous gamma globulin (IVIG) along with conventional anti-congestive therapy. Group 2 were patients who received the conventional anticongestive therapy alone. Short-term outcome was survival to hospital discharge, and mid-term outcome was improvement of left ventricular ejection fraction at 6 months and one year follow-up. Results: A total of 36 patients were enrolled and 18 were males. The mean age of all patients was 2.3 ± 2.6 years and the mean duration of illness for the whole group was 6.7 ± 3.8 days. Group 1 comprised of 16 patients. There was no difference in short-term outcome with mortality of 2 patients in Group1 (12.5%) and 3(15%) in Group 2 (p = 0.2). At intermediate term follow up, recovery of ejection fraction in Group 1 was in 4/14 (28%) and in Group 2 it was 9/17 (55%) and at 12 months it was 10/13 (77%) in Group 1 and 15/16 (94%) in Group 2 (p = 0.02 and 0.19 respectively). Conclusion: Acute myocarditis has a high spontaneous cure rate. Our study did not show any significant difference in the short-term or midterm outcome between children receiving IVIG compared to those who did not.
文摘目的:探讨丙种球蛋白无反应及敏感川崎病患儿血小板(PLT)、干扰素-γ(IFN-γ)、白介素-6(IL-6)表达水平的差异及临床意义。方法:选取2019年5月至2022年6月厦门大学附属中山医院收治的99例川崎病患儿,根据丙种球蛋白治疗反应性分为无反应组24例和敏感组75例,比较两组基线水平及12 h、36 h PLT、IFN-γ、IL-6表达水平。采用Logistic回归分析川崎病丙种球蛋白无反应的相关影响因素,采用受试者工作特征曲线(ROC)分析PLT、IFN-γ、IL-6及联合预测川崎病丙种球蛋白无反应的价值,采用DeLong检验不同方案的预测价值,采用临床决策曲线分析法(DCA)分析PLT+IFN-γ+IL-6方案预测川崎病丙种球蛋白反应性的临床效用。结果:无反应组12 h及36 h PLT、IFN-γ、IL-6表达水平与基线水平比较,差异无统计学意义(P>0.05);敏感组12 h及36 h PLT、IFN-γ、IL-6表达水平均低于基线水平(P<0.05);无反应组基线水平及12 h、36 h PLT、IFN-γ、IL-6表达水平高于敏感组(P<0.05);基线PLT、IFN-γ、IL-6均为川崎病丙种球蛋白无反应的独立相关影响因素(P<0.05);PLT、IFN-γ、IL-6及联合的ROC曲线下面积(AUC)依次为0.818、0.767、0.712、0.915,PLT+IFN-γ+IL-6的AUC高于IFN-γ、IL-6(P<0.05),与PLT比较,差异无统计学意义(P>0.05);采用PLT+IFN-γ+IL-6方案预测川崎病丙种球蛋白无反应具有临床正向的净获益。结论:川崎病丙种球蛋白无反应和敏感患儿PLT、IFN-γ、IL-6表达水平存在显著差异,与患儿治疗反应性有关,联合检测PLT、IFN-γ、IL-6可预测丙种球蛋白治疗反应。
