疑似病毒性心肌炎兒童頻發(fā)房性期前收縮的近期隨訪
發(fā)布時間：2018-12-07 12:03
【摘要】：目的 病毒性心肌炎是兒童常見的心血管疾病,但是典型病毒性心肌炎或重癥心肌炎發(fā)生率低,臨床多見以頻發(fā)期前收縮為主要臨床表現(xiàn)的兒童,無或有輕微的心肌酶升高,對于這一部分患者,病毒性心肌炎不能確診也不能排除,并進一步?jīng)Q定著相關(guān)的治療。我院兒科對此類病例按病毒性心肌炎治療后,確有部分患者期前收縮明顯減少,反證了病毒性心肌炎的診斷�；诖�,我們回顧性分析我院兒科自2002年至2012年收治的伴有頻發(fā)房性期前收縮的此類病例,總結(jié)其治療效果,分析其心電學指標,探討疑似病毒性心肌炎兒童頻發(fā)房性期前收縮的特點及近期預后,以為此類病例的診治提供依據(jù)。 方法 調(diào)閱我院兒科自2002年至2012年收治的以頻發(fā)房性期前收縮為主要臨床表現(xiàn)的疑似病毒性心肌炎患兒41例,總結(jié)其臨床特點,包括有無前驅(qū)感染史,有無心功能不全或心源性休克的癥狀,心肌酶、超聲心動圖、心臟正位片等輔助檢查結(jié)果,回顧性分析其動態(tài)心電圖特點包括異位心搏總數(shù),是否為房性并行心律,有無合并房性心動過速,聯(lián)律間期是否固定,期前收縮的起源、形態(tài)等,并對營養(yǎng)心肌治療后房性期前收縮總數(shù)的變化進行統(tǒng)計描述,對動態(tài)心電圖特點與預后的關(guān)系進行統(tǒng)計推斷。 結(jié)果 130例(73%)全天房性期前收縮總數(shù)小于20000,4例(10%)為房性并行心律,35例(85%)心房異位P'波可提前至T波,14例(32%)合并房性心動過速,多數(shù)病例期前收縮為單源性、起源于心房下部。 2給予兩周抗病毒、營養(yǎng)心肌、抗氧化及中成藥治療后,半數(shù)患兒房性期前收縮減少超過30%。 3合并房性心動過速者比單純頻發(fā)房性期前收縮者近期預后好(P0.05)。 結(jié)論 疑似病毒性心肌炎兒童的頻發(fā)房性期前收縮,尤其是合并房性心動過速者,多為病毒性心肌炎引起,按病毒性心肌炎治療可使期前收縮減少或消失。
[Abstract]:Objective viral myocarditis is a common cardiovascular disease in children, but the incidence of typical viral myocarditis or severe myocarditis is low. There is no or slight increase in myocardial enzymes, and for this group of patients, viral myocarditis cannot be diagnosed and ruled out, and further related treatment is determined. After treatment with viral myocarditis in paediatrics, some of the patients did have a marked decrease in phase contraction, which confirmed the diagnosis of viral myocarditis. Based on this, we retrospectively analyzed the patients with frequent atrial premature contraction in pediatrics from 2002 to 2012, summarized their therapeutic effects, and analyzed their ECG indexes. To investigate the characteristics and prognosis of frequent atrial premature contraction in children with suspected viral myocarditis, and to provide evidence for the diagnosis and treatment of these cases. Methods from 2002 to 2012, 41 children with suspected viral myocarditis with frequent atrial premature contraction as the main clinical manifestation were reviewed, and their clinical characteristics were summarized, including whether they had a history of precancerous infection. Whether there are symptoms of cardiac insufficiency or cardiogenic shock, myocardial enzyme, echocardiography, positive position radiography and other auxiliary examination results, the dynamic electrocardiogram features, including the total number of ectopic cardiac beats, whether atrial concurrent rhythm, were analyzed retrospectively. With or without atrial tachycardia, whether the syntonic interval is fixed or not, the origin and morphology of the premature contraction, etc., and the changes of the total number of atrial premature contractions after the treatment of nutritious myocardium were statistically described. The relationship between the characteristics of ambulatory electrocardiogram (ECG) and prognosis was statistically inferred. Results in 130 cases (73%), the total number of total atrial premature contractions was less than 20 000% (10%) in 4 cases (10%), atrial concurrent rhythm in 35 cases (85%), atrial ectopic P 'wave in 35 cases (85%), atrial tachycardia in 14 cases (32%), atrial tachycardia in 14 cases (32%). In most cases, the preterm contraction was monogenic and originated in the lower atrium. 2 after two weeks of antiviral, nutritional myocardial, antioxidant and traditional Chinese medicine treatment, the atrial premature contraction decreased by more than 30% in half of the children. 3The short-term prognosis of patients with atrial tachycardia was better than that of patients with simple frequent atrial premature contraction (P0.05). Conclusion the frequent atrial premature contraction in children with suspected viral myocarditis, especially in patients with atrial tachycardia, is mostly caused by viral myocarditis.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R725.1
本文編號：2367174
[Abstract]:Objective viral myocarditis is a common cardiovascular disease in children, but the incidence of typical viral myocarditis or severe myocarditis is low. There is no or slight increase in myocardial enzymes, and for this group of patients, viral myocarditis cannot be diagnosed and ruled out, and further related treatment is determined. After treatment with viral myocarditis in paediatrics, some of the patients did have a marked decrease in phase contraction, which confirmed the diagnosis of viral myocarditis. Based on this, we retrospectively analyzed the patients with frequent atrial premature contraction in pediatrics from 2002 to 2012, summarized their therapeutic effects, and analyzed their ECG indexes. To investigate the characteristics and prognosis of frequent atrial premature contraction in children with suspected viral myocarditis, and to provide evidence for the diagnosis and treatment of these cases. Methods from 2002 to 2012, 41 children with suspected viral myocarditis with frequent atrial premature contraction as the main clinical manifestation were reviewed, and their clinical characteristics were summarized, including whether they had a history of precancerous infection. Whether there are symptoms of cardiac insufficiency or cardiogenic shock, myocardial enzyme, echocardiography, positive position radiography and other auxiliary examination results, the dynamic electrocardiogram features, including the total number of ectopic cardiac beats, whether atrial concurrent rhythm, were analyzed retrospectively. With or without atrial tachycardia, whether the syntonic interval is fixed or not, the origin and morphology of the premature contraction, etc., and the changes of the total number of atrial premature contractions after the treatment of nutritious myocardium were statistically described. The relationship between the characteristics of ambulatory electrocardiogram (ECG) and prognosis was statistically inferred. Results in 130 cases (73%), the total number of total atrial premature contractions was less than 20 000% (10%) in 4 cases (10%), atrial concurrent rhythm in 35 cases (85%), atrial ectopic P 'wave in 35 cases (85%), atrial tachycardia in 14 cases (32%), atrial tachycardia in 14 cases (32%). In most cases, the preterm contraction was monogenic and originated in the lower atrium. 2 after two weeks of antiviral, nutritional myocardial, antioxidant and traditional Chinese medicine treatment, the atrial premature contraction decreased by more than 30% in half of the children. 3The short-term prognosis of patients with atrial tachycardia was better than that of patients with simple frequent atrial premature contraction (P0.05). Conclusion the frequent atrial premature contraction in children with suspected viral myocarditis, especially in patients with atrial tachycardia, is mostly caused by viral myocarditis.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R725.1
【參考文獻】
相關(guān)期刊論文 前10條
1 王步青;王衛(wèi)東;;心率變異性分析方法的研究進展[J];北京生物醫(yī)學工程;2007年05期
2 朱靜;;動態(tài)心電圖對充血性心力衰竭合并房性心律失常的研究[J];當代醫(yī)學;2012年14期
3 劉玉玉;王義成;馬姝穎;幺雯;;急性腦卒中患者竇性心率震蕩與心率變異性臨床觀察[J];河北醫(yī)藥;2011年12期
4 劉亞男;室性早搏的心電圖特征與治療的關(guān)系[J];黑龍江醫(yī)學;2002年12期
5 陳保利,劉天華;吞咽誘發(fā)快速型房性心律失常的機理[J];實用診斷與治療雜志;2004年01期
6 周愛卿,王榮發(fā),嚴錦蘭;小兒室性早搏的遠期隨訪:附139例分析[J];臨床兒科雜志;1997年03期
7 吳宗華;口服心律平治療室性期前收縮二聯(lián)律致竇性停搏1例[J];臨床薈萃;2001年14期
8 楊紅,林華;呼吸周期性房性期前收縮伴房性心動過速1例[J];臨床心血管病雜志;2001年06期
9 時向民;王玉堂;單兆亮;趙立朝;楊庭樹;;短聯(lián)律間期房性期前收縮誘發(fā)心房顫動的電生理機制[J];臨床心血管病雜志;2010年04期
10 郭繼鴻;P波離散度[J];臨床心電學雜志;1999年03期
，本文編號：2367174
本文鏈接：http://sikaile.net/yixuelunwen/eklw/2367174.html
最近更新
教材專著
