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2023-02-22 17:00:26

病毒性心肌炎最有诊断价值的检查(女性23岁诊断急性病毒性心肌炎)

根据世界卫生组织及国际心脏病联合会的定义,心肌炎为心肌细胞的炎症性疾病,诊断依据为心内膜心肌活检(endomyocardial biopsy,EMB)组织学、免疫学及免疫组织化学证实的炎症细胞浸润[1]。病毒性心肌炎是由病毒感染引起的心肌间质炎症细胞浸润和邻近的心肌细胞坏死、变性,有时病变也可累及心包或心内膜[2]

心肌炎在儿童中罕见,估计年发病率为1~2/100000[3,4]。据报道,心肌炎患儿急性期的死亡率为6%~14%[4,5],大约5%~20%的急性心肌炎儿童需要心脏移植[6, 7]

儿童心肌炎的诊断难度大,依赖于对病史、临床症状和辅助检查的综合评估和动态随访,目前尚无国际统一的儿童心肌炎诊断标准。那么儿童病毒性心肌炎诊断和治疗的要点有哪些内容呢?请点击下图进入医脉通的诊疗知识库产品——《医知源疾病知识库》,由四川省妇幼保健院儿科王元丽医生撰写的儿童病毒性心肌炎疾病知识,全面展示了儿童病毒性心肌炎的诊断和治疗,除此之外,该词条还涉及病因、流行病学、发生机制、筛查流程、预防与康复的内容。

参考资料:

[1]Richardson P,Mckenna W,Bristow M,et al.Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies[J].Circulation,1996,93(5):841-842.

[2]王卫平,孙琨,常立文.儿科学(第9版)[M].北京:人民卫生出版社,2021:279-281.

[3]Arola A,Pikkarainen E,Sipilä J O,et al.Occurrence and Features of Childhood Myocarditis: A Nationwide Study in Finland[J].J Am Heart Assoc,2017,6(11), e005306.(影响因子:5.541)

[4]Wu M H,Wu E T,Wang C C,et al.Contemporary Postnatal Incidence of Acquiring Acute Myocarditis by Age 15 Years and the Outcomes From a Nationwide Birth Cohort[J].Pediatr Crit Care Med,2017,18(12):1153-1158.

[5]Jlee K,Wmccrindle B,Jbohn D,et al.Clinical outcomes of acute myocarditis in childhood[J].Heart,1999,82(2):226-233.

[6]Butts R J,Boyle G J,Deshpande S R,et al.Characteristics of Clinically Diagnosed Pediatric Myocarditis in a Contemporary Multi-Center Cohort[J]. Pediatr Cardiol, 2017, 38(6): 1175-1182.

[7]Ghelani S J,Spaeder M C, Pastor W,et al.Demographics, trends, and outcomes in pediatric acute myocarditis in the United States, 2006 to 2011[J].Circ Cardiovasc QualOutcomes,2012,5(5):622-627.