摘要
目的分析儿童暴发性心肌炎的临床特点及危险因素。方法回顾82例心肌炎患儿临床资料,其中暴发性心肌炎(FM)组16例,非暴发性心肌炎(非FM)组66例,分析影响暴发性心肌炎发生的危险因素。结果单因素分析结果显示,FM组面色苍白、气促、低血压、心音低钝、房性心动过速、心影增大、室壁运动减弱、室间隔增厚、左室射血分数(LVEF)下降、左室缩短率(LVFS)下降、WBC、PLT、AST、ALT、LDH、BNP、CKMB-mass、cTnI均高于非FM组(P<0.01)。Logistic回归分析结果显示,LVEF和BNP是儿童FM的独立危险因素(P<0.05)。经ROC曲线下面积计算得出LVEF、BNP的临界值分别为55.50%、17.50 pg/ml。结论儿童FM临床表现不典型,当心肌炎患儿临床指标中出现LVEF≤55.50%或BNP≥17.50 pg/ml时,均提示发生FM的可能性增加。
Objective To investigate the clinical characteristics and risk factors of fulminant myocar⁃ditis(FM)in children.Method Clinical data of 82 children with myocarditis were retrospectively ana⁃lyzed,including 16 cases of fulminant myocarditis and 66 cases of non-fulminant myocarditis.To investi⁃gate the risk factors of fulminant myocarditis in children.Results Univariate analysis showed that The FM group had higher paleness,shortness of breath,hypotension,low blunt heart sound,atrial tachycardia,enlarged heart shade,weakened wall motion,thickened ventricular septum,decreased left ventricular ejection fraction(LVEF),decreased left ventricular shortening rate(LVFS),WBC,PLT,AST,ALT,LDH,BNP,CKMB-MASS and cTnI than the non-FM group(P<0.01).Logistic regression analysis showed that LVEF and BNP were independent risk factors for FM in children(P<0.05).The critical values of LVEF and BNP were 55.50%and 17.50 pg/ml,respectively,according to the area under the ROC curve.Con⁃clusion The clinical manifestations of FM in children are not typical.When LVEF≤55.50%or BNP≥17.50 pg/ml in clinical indicators of children with myocarditis,the possibility of FM is increased.
作者
石春武
Shi Chunwu(Changzhou Children's Hospital,Changzhou 213003 Jiangsu Province)
出处
《常州实用医学》
2022年第4期211-215,共5页
CHANGZHOU PRACTICAL MEDICINE
关键词
暴发性心肌炎
临床特点
危险因素
儿童
fulminant myocarditis
Clinical characteristics
Risk factors
children
