国际儿科学杂志
國際兒科學雜誌
국제인과학잡지
INTERNATIONAL JOURNAL OF PEDIATRICS
2013年
2期
214-217
,共4页
彭静%邓淑珍%王瑞耕%刘玲%孙东明%夏琨
彭靜%鄧淑珍%王瑞耕%劉玲%孫東明%夏琨
팽정%산숙진%왕서경%류령%손동명%하곤
扩张型心肌病%病因%心律失常%儿童
擴張型心肌病%病因%心律失常%兒童
확장형심기병%병인%심률실상%인동
Dilated cardiomyopathy%Etiology%Arrhythmia%Children
目的 探讨小儿扩张型心肌病(dilated cardiomyopathy,DCM)的发病年龄、病因、心功能状况及心律失常的特点.方法 对我院2002年1月至2011年12月收治的112例DCM患儿的发病年龄、病因、临床特点进行分析,并按心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级分为4组,比较各组心律失常的发生率及类型.结果 112例DCM患儿中,＜1岁确诊的52例(46.42％)；诊断时有心力衰竭107例(95.53％)；能明确病因的25例(22.32％),其中心肌炎16例(14.28％),家族性单纯DCM 5例(4.46％),原发性肉碱缺乏症2例(1.78％),Duchenne肌营养不良1例(0.89％),药物毒性反应(阿霉素)所致DCM 1例(0.89％)；96例(85.71％)患儿出现各种心律失常.按心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ级分级的4组中,各组出现1种心律失常的发生率分别为20.00％、31.25％、36.17％和42.85％,出现2种以上心律失常者的发生率分别为0、18.75％、38.29％和50.00％,出现恶性心律失常的发生率分别为0、12.50％、40.42％和67.85％.心功能Ⅱ、Ⅲ、Ⅳ级组间比较差异有统计学意义(P＜0.05).结论 小儿DCM在1岁以内发病率最高；其主要病因有心肌炎、家族性、代谢缺陷及神经肌肉疾病等；心力衰竭常为患儿的首发症状及主要临床表现；DCM的心律失常发生率高且多样,常为多种心律失常并存,且心律失常的发生与患儿心功能密切相关；小儿DCM各系统栓塞罕见.
目的 探討小兒擴張型心肌病(dilated cardiomyopathy,DCM)的髮病年齡、病因、心功能狀況及心律失常的特點.方法 對我院2002年1月至2011年12月收治的112例DCM患兒的髮病年齡、病因、臨床特點進行分析,併按心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ級分為4組,比較各組心律失常的髮生率及類型.結果 112例DCM患兒中,＜1歲確診的52例(46.42％)；診斷時有心力衰竭107例(95.53％)；能明確病因的25例(22.32％),其中心肌炎16例(14.28％),傢族性單純DCM 5例(4.46％),原髮性肉堿缺乏癥2例(1.78％),Duchenne肌營養不良1例(0.89％),藥物毒性反應(阿黴素)所緻DCM 1例(0.89％)；96例(85.71％)患兒齣現各種心律失常.按心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ級分級的4組中,各組齣現1種心律失常的髮生率分彆為20.00％、31.25％、36.17％和42.85％,齣現2種以上心律失常者的髮生率分彆為0、18.75％、38.29％和50.00％,齣現噁性心律失常的髮生率分彆為0、12.50％、40.42％和67.85％.心功能Ⅱ、Ⅲ、Ⅳ級組間比較差異有統計學意義(P＜0.05).結論 小兒DCM在1歲以內髮病率最高；其主要病因有心肌炎、傢族性、代謝缺陷及神經肌肉疾病等；心力衰竭常為患兒的首髮癥狀及主要臨床錶現；DCM的心律失常髮生率高且多樣,常為多種心律失常併存,且心律失常的髮生與患兒心功能密切相關；小兒DCM各繫統栓塞罕見.
목적 탐토소인확장형심기병(dilated cardiomyopathy,DCM)적발병년령、병인、심공능상황급심률실상적특점.방법 대아원2002년1월지2011년12월수치적112례DCM환인적발병년령、병인、림상특점진행분석,병안심공능Ⅰ、Ⅱ、Ⅲ、Ⅳ급분위4조,비교각조심률실상적발생솔급류형.결과 112례DCM환인중,＜1세학진적52례(46.42％)；진단시유심력쇠갈107례(95.53％)；능명학병인적25례(22.32％),기중심기염16례(14.28％),가족성단순DCM 5례(4.46％),원발성육감결핍증2례(1.78％),Duchenne기영양불량1례(0.89％),약물독성반응(아매소)소치DCM 1례(0.89％)；96례(85.71％)환인출현각충심률실상.안심공능Ⅰ、Ⅱ、Ⅲ、Ⅳ급분급적4조중,각조출현1충심률실상적발생솔분별위20.00％、31.25％、36.17％화42.85％,출현2충이상심률실상자적발생솔분별위0、18.75％、38.29％화50.00％,출현악성심률실상적발생솔분별위0、12.50％、40.42％화67.85％.심공능Ⅱ、Ⅲ、Ⅳ급조간비교차이유통계학의의(P＜0.05).결론 소인DCM재1세이내발병솔최고；기주요병인유심기염、가족성、대사결함급신경기육질병등；심력쇠갈상위환인적수발증상급주요림상표현；DCM적심률실상발생솔고차다양,상위다충심률실상병존,차심률실상적발생여환인심공능밀절상관；소인DCM각계통전새한견.
Objective To determine the etiology and clinical characteristics of children with dilated cardiomyopathy.Methods 112 children with DCM from January 2002 to December 2011 were studied.The age,cause and the clinical manifestations were analyzed.According to the children with heart function,they were divided into four groups,the incidence and type of arrhythmia were compared.Results In 112 cases of DCM in children,＜ 1 year old diagnosed 52 cases (46.42％),107 cases (95.53％) with heart failure,25 cases (22.32％) with chear causes,96 cases(85.71％) children with a variety of arrhythmias.According to cardiac function in Ⅰ,Ⅱ and Ⅲ and Ⅳ level,they were divided into four groups.The incidence of one kind of arrhythrnia were 20.00％,31.25％,36.17％ and 42.85％.The incidence with two or more kinds of arrhythmia was 0,18.75％,38.29％ and 50.00％ respectively.The incidence of malignant arrhythmia was 0,12.50％,40.42％and 67.85％ in different groups.There was significant differences among the groups of Ⅱ and Ⅲ and Ⅳ level (P ＜ 0 05).Conclusion Children with dilated cardiomyopathy disease younger than I year old had the highest incidence.The major causes were myocarditis,hereditary and congenital metabolic diseases.The incidence of arrhythmia in DCM were high and diverse,often exist for a variety of arrhythmia,and arrhythmia have closely relation with heart function.The embolism in children with DCM was very rare.
