中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2012年
10期
1323-1326
,共4页
病毒性疾病/病理生理学%电位测定法%急性病%心肌炎/病理生理学%心室
病毒性疾病/病理生理學%電位測定法%急性病%心肌炎/病理生理學%心室
병독성질병/병리생이학%전위측정법%급성병%심기염/병리생이학%심실
Virus diseases/physiopathology%Potentiometry%Acute disease%Myocarditis/physiopathology%Heart ventricles
目的 探讨小儿病毒性心肌炎的心室晚电位(VLP)与其病情程度、心功能之间的关系,为临床判定患儿病情和治疗提供依据.方法 将本院152例病毒性心肌炎患儿按病情程度分为轻症组(128例)和重症组(24例).重症组患儿病情程度分为严重心律失常组(10例),急性心功能衰竭组(心衰组,9例),心源性休克组(休克组,5例).选择本院同期50名健康体检正常儿童为对照组.各组分别抽血检测cTnI水平,并进行VLP检查,病例组患儿行彩色超声心动图检查,比较各组血清cTnI水平、与VLP及心功能指标的变化.结果 轻症组患儿经治疗后痊愈出院,重症组中7例死于急性期,余患儿均抢救成功并治愈(70.8％).轻症组和对照组VLP均为阴性,重症组VLP阳性率为75.0％ (18/24),可疑阳性率12.5％ (3/24),3例为阴性(12.5％).重型VMC组与轻症组相比,LAS明显延长(P＜0.01),RMS40明显降低(P＜0.05).重型VMC组与对照组相比,QRST延长(P＜0.05),LAS明显延长(P＜0.01),RMS40明显降低(P＜0.01).重症组中严重心律失常组VLP阳性率为60.0％ (6/10),心衰组VLP阳性率为77.78％ (7/9),休克组VLP阳性率为100％ (5/5),随病情加重而VLP阳性率升高(P＜0.05).重症VMC的VLP中LAS、RMS40与LVFS呈等级负相关(r=-0.404,-0.372,P＜0.05).结论 轻症病毒性心肌炎患儿血清肌钙蛋白(cTnI)水平升高,心室晚电位阴性其预后良好;重症患儿血清肌钙蛋白(cTnI)水平升高,心室晚电位阳性其病情凶险,及时救治可改善预后.血清肌钙蛋白(cTnI)水平及心室晚电位(VLP)对病毒性心肌炎的诊断、病情严重程度的甄别及预后有指导作用.
目的 探討小兒病毒性心肌炎的心室晚電位(VLP)與其病情程度、心功能之間的關繫,為臨床判定患兒病情和治療提供依據.方法 將本院152例病毒性心肌炎患兒按病情程度分為輕癥組(128例)和重癥組(24例).重癥組患兒病情程度分為嚴重心律失常組(10例),急性心功能衰竭組(心衰組,9例),心源性休剋組(休剋組,5例).選擇本院同期50名健康體檢正常兒童為對照組.各組分彆抽血檢測cTnI水平,併進行VLP檢查,病例組患兒行綵色超聲心動圖檢查,比較各組血清cTnI水平、與VLP及心功能指標的變化.結果 輕癥組患兒經治療後痊愈齣院,重癥組中7例死于急性期,餘患兒均搶救成功併治愈(70.8％).輕癥組和對照組VLP均為陰性,重癥組VLP暘性率為75.0％ (18/24),可疑暘性率12.5％ (3/24),3例為陰性(12.5％).重型VMC組與輕癥組相比,LAS明顯延長(P＜0.01),RMS40明顯降低(P＜0.05).重型VMC組與對照組相比,QRST延長(P＜0.05),LAS明顯延長(P＜0.01),RMS40明顯降低(P＜0.01).重癥組中嚴重心律失常組VLP暘性率為60.0％ (6/10),心衰組VLP暘性率為77.78％ (7/9),休剋組VLP暘性率為100％ (5/5),隨病情加重而VLP暘性率升高(P＜0.05).重癥VMC的VLP中LAS、RMS40與LVFS呈等級負相關(r=-0.404,-0.372,P＜0.05).結論 輕癥病毒性心肌炎患兒血清肌鈣蛋白(cTnI)水平升高,心室晚電位陰性其預後良好;重癥患兒血清肌鈣蛋白(cTnI)水平升高,心室晚電位暘性其病情兇險,及時救治可改善預後.血清肌鈣蛋白(cTnI)水平及心室晚電位(VLP)對病毒性心肌炎的診斷、病情嚴重程度的甄彆及預後有指導作用.
목적 탐토소인병독성심기염적심실만전위(VLP)여기병정정도、심공능지간적관계,위림상판정환인병정화치료제공의거.방법 장본원152례병독성심기염환인안병정정도분위경증조(128례)화중증조(24례).중증조환인병정정도분위엄중심률실상조(10례),급성심공능쇠갈조(심쇠조,9례),심원성휴극조(휴극조,5례).선택본원동기50명건강체검정상인동위대조조.각조분별추혈검측cTnI수평,병진행VLP검사,병례조환인행채색초성심동도검사,비교각조혈청cTnI수평、여VLP급심공능지표적변화.결과 경증조환인경치료후전유출원,중증조중7례사우급성기,여환인균창구성공병치유(70.8％).경증조화대조조VLP균위음성,중증조VLP양성솔위75.0％ (18/24),가의양성솔12.5％ (3/24),3례위음성(12.5％).중형VMC조여경증조상비,LAS명현연장(P＜0.01),RMS40명현강저(P＜0.05).중형VMC조여대조조상비,QRST연장(P＜0.05),LAS명현연장(P＜0.01),RMS40명현강저(P＜0.01).중증조중엄중심률실상조VLP양성솔위60.0％ (6/10),심쇠조VLP양성솔위77.78％ (7/9),휴극조VLP양성솔위100％ (5/5),수병정가중이VLP양성솔승고(P＜0.05).중증VMC적VLP중LAS、RMS40여LVFS정등급부상관(r=-0.404,-0.372,P＜0.05).결론 경증병독성심기염환인혈청기개단백(cTnI)수평승고,심실만전위음성기예후량호;중증환인혈청기개단백(cTnI)수평승고,심실만전위양성기병정흉험,급시구치가개선예후.혈청기개단백(cTnI)수평급심실만전위(VLP)대병독성심기염적진단、병정엄중정도적견별급예후유지도작용.
Objective Explore the relationship of ventricular late potential (VLP) and the heart function of children with viral myocarditis,and provide the evidence for their diagnosis and therapy.Methods The clinical data of 152 cases of epileptic children were collected.The patient group was divided into three groups (severe arrhythmia,heart failure,and cardiogenic shock).The patient group was also divided into two groups (cardiac dilatation,and non-cardiac dilatation) according to UCG.Serum levels of cTnI and VLP in children with viral myocarditis were detected.Results The VLP was negative in the mild and control groups,but the positive rate of VLP is 75.0 ％ in the severe group.The positive rate of VLP was 60.0％ in the severe arrhythmia group,77.78％ in the heart failure group,and 100％ in the shock group.There is one kind of negative rank correlation between LAS,RMS40 and LVFS (P ＜ 0.05),and another negative rank correlation between RMS40 and LVEF (P ＜ 0.05).Conclusions The children with viral myocarditis have a favorable prognosis.The sever patient in the minority must be diagnosed in time and treated because of the critical state of viral myocarditis children.The serum level of cTnI and VLP were increased in children with viral myocarditis,and they were sensitive parameters to reflect patients’ condition.
