疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2014年
7期
668-670
,共3页
李兴朝%王茜%谢集建%李涛
李興朝%王茜%謝集建%李濤
리흥조%왕천%사집건%리도
心肌炎,新生儿%临床特征%白细胞介素-6%肿瘤坏死因子-α
心肌炎,新生兒%臨床特徵%白細胞介素-6%腫瘤壞死因子-α
심기염,신생인%림상특정%백세포개소-6%종류배사인자-α
Myocarditis,neonatal%Clinical characteristics%Interleukin-6%Tumor necrosis factor-α
目的：分析新生儿心肌炎的临床特征，并探讨患儿血清白细胞介素-6（ IL-6）、肿瘤坏死因子-α（ TNF-α）水平的变化。方法选择2007年5月-2013年2月新生儿心肌炎患者85例，并分为急性期亚组53例，恢复期亚组32例，同时选择同期健康新生儿50例为健康对照组。观察85例新生儿心肌炎患儿的临床表现、心电图、X线胸片特点以及心肌酶谱、血清病毒抗体检测结果；采用酶联免疫吸附双抗体夹心试验检测血清IL-6、TNF-α水平，并对3组进行比较。结果心肌炎患儿主要临床表现有精神反应差、面色发灰、气促、发绀、拒乳、心音低钝、烦躁不安、发热、腹泻等；心电图显示房室传导阻滞38例（44梃．7％），X线胸片显示中心影增大59例（69．4％）；心脏彩色超声显示先天性心脏病35例（41．2％），其中房间隔缺损26例，室间隔缺损9例。所有患儿心肌酶检测异常，病毒抗体检测阳性56例（65．9％），主要有柯萨奇B组病毒、腺病毒和巨细胞包涵体病毒。急性期亚组患儿血清IL-6、TNF-α水平显著高于恢复期亚组及健康对照组，组间相比差异具有统计学意义（ t ＝20．573，14．631， P ＜0．05）；而恢复期亚组与健康对照组相比差异无统计学意义（ t ＝1．312，1．384， P ＞0．05）。结论新生儿心肌炎有其特有的临床特征，血清IL-6、TNF-α检测对疾病诊断、治疗有着重要意义。
目的：分析新生兒心肌炎的臨床特徵，併探討患兒血清白細胞介素-6（ IL-6）、腫瘤壞死因子-α（ TNF-α）水平的變化。方法選擇2007年5月-2013年2月新生兒心肌炎患者85例，併分為急性期亞組53例，恢複期亞組32例，同時選擇同期健康新生兒50例為健康對照組。觀察85例新生兒心肌炎患兒的臨床錶現、心電圖、X線胸片特點以及心肌酶譜、血清病毒抗體檢測結果；採用酶聯免疫吸附雙抗體夾心試驗檢測血清IL-6、TNF-α水平，併對3組進行比較。結果心肌炎患兒主要臨床錶現有精神反應差、麵色髮灰、氣促、髮紺、拒乳、心音低鈍、煩躁不安、髮熱、腹瀉等；心電圖顯示房室傳導阻滯38例（44梃．7％），X線胸片顯示中心影增大59例（69．4％）；心髒綵色超聲顯示先天性心髒病35例（41．2％），其中房間隔缺損26例，室間隔缺損9例。所有患兒心肌酶檢測異常，病毒抗體檢測暘性56例（65．9％），主要有柯薩奇B組病毒、腺病毒和巨細胞包涵體病毒。急性期亞組患兒血清IL-6、TNF-α水平顯著高于恢複期亞組及健康對照組，組間相比差異具有統計學意義（ t ＝20．573，14．631， P ＜0．05）；而恢複期亞組與健康對照組相比差異無統計學意義（ t ＝1．312，1．384， P ＞0．05）。結論新生兒心肌炎有其特有的臨床特徵，血清IL-6、TNF-α檢測對疾病診斷、治療有著重要意義。
목적：분석신생인심기염적림상특정，병탐토환인혈청백세포개소-6（ IL-6）、종류배사인자-α（ TNF-α）수평적변화。방법선택2007년5월-2013년2월신생인심기염환자85례，병분위급성기아조53례，회복기아조32례，동시선택동기건강신생인50례위건강대조조。관찰85례신생인심기염환인적림상표현、심전도、X선흉편특점이급심기매보、혈청병독항체검측결과；채용매련면역흡부쌍항체협심시험검측혈청IL-6、TNF-α수평，병대3조진행비교。결과심기염환인주요림상표현유정신반응차、면색발회、기촉、발감、거유、심음저둔、번조불안、발열、복사등；심전도현시방실전도조체38례（44정．7％），X선흉편현시중심영증대59례（69．4％）；심장채색초성현시선천성심장병35례（41．2％），기중방간격결손26례，실간격결손9례。소유환인심기매검측이상，병독항체검측양성56례（65．9％），주요유가살기B조병독、선병독화거세포포함체병독。급성기아조환인혈청IL-6、TNF-α수평현저고우회복기아조급건강대조조，조간상비차이구유통계학의의（ t ＝20．573，14．631， P ＜0．05）；이회복기아조여건강대조조상비차이무통계학의의（ t ＝1．312，1．384， P ＞0．05）。결론신생인심기염유기특유적림상특정，혈청IL-6、TNF-α검측대질병진단、치료유착중요의의。
Objective To analyse the clinical characteristics of neonatal myocarditis , and to explore the changes of serum interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) levels.Methods From 2007 May to 2013 February, 85 cases of patients with myocarditis were enrolled , they were divided into acute period subgroup with 53 cases, recovery subgroup with 32 cases, over the same period, 50 cases of healthy infants were enrolled as control group .Observation of clinical manifesta-tion, electrocardiogram , chest X-ray features and myocardial enzymes , serum virus antibody test results in 85 cases of newborn children with myocarditis;using enzyme linked immunosorbent assay ( ELISA) test for the detection of serum IL-6, TNF-αlevels, and compared among the 3 groups.Results Viral myocarditis children's main clinical manifestations including poor mental reaction, pale, shortness of breath, cyanosis, milk refusal, low heart sound blunt, restlessness, fever, diarrhea;elec-trocardiogram showed atrioventricular block in 38 cases (44.7%), chest X-ray film showed increased in 59 cases (69.4%);heart color ultrasound showed 35 cases with congenital heart disease (41.2%), including 26 cases of atrial septal defect, 9 cases of ventricular septal defect .Detection of abnormal myocardial enzymes was found in all of the children , virus antibody test was positive in 56 patients (65.9%), mainly were Coxsackie B virus, adenovirus and cytomegalovirus (CMV).Acute period subgroup ’ s serum IL-6, TNF-αlevels were significantly higher in recovery period subgroup and healthy control group , the difference was statistically significant among groups ( t =20.573, 14.631, P <0.05); and the recovery period of sub-group and the healthy control group was showed no significant difference ( t =1.312,1.384, P >0.05).Conclusion Neo-natal myocarditis has its own clinical manifestation , detection of serum IL-6, TNF-αhas great significant for the diagnosis and treatment of the disease .
