儿童巨细胞病毒性心肌炎38例临床分析及发病机制研究

摘要

目的 探讨巨细胞病毒性心肌炎患儿的临床特征及其发病机制.方法 回顾性分析2014年1月至2014年12月湖北省妇幼保健院收治的38例巨细胞病毒心肌炎患儿的临床资料.结果 患儿发病平均年龄为(2.01±1.53)岁,临床上以发热、乏力、腹泻、黄疸等为主要表现,心肌酶谱、抗心肌抗体、肌钙蛋白I、心电图、胸部X线及心脏超声的异常检出率分别为94.73％,68.42％,60.53％,86.84％,23.68％和21.05％.结论 儿童巨细胞病毒性心肌炎以婴儿多见,其临床特征缺乏特异性,联合运用心肌酶谱、心电图、心脏超声及胸部X线等检查有助于确诊.抗心肌抗体参与了巨细胞病毒性心肌炎的发病,是其重要免疫标志物之一.%Objective To investigate the clinical features and pathogenesis of children with myocarditis infected by cytomegalovirus.Methods Analyzed retrospectively the clinical data of 38 cases children with myocarditis infected by cytomegalovirus in pediatrics inpatients of Maternal and Child Health Hospital of Hubei province from January 2014 to December 2014.Results The mean age of children patients was (2.01±1.53)years old. The main clinical symptoms were fever, acratia, diarrhea, jaundice and so on. The abnormal detection rate of myocardial enzymogram, antimyocardial antibody, cardiac troponin I, electrocardiogram, chest X-ray and echocardiography were 94.73％, 68.42％, 60.53％, 86.84％, 23.68％ and 21.05％, respectively.Conclusion Viral myocarditis infected by cytomegalovirus was common in infants; its clinical features were nonspeciifc. The examination of myocardial enzymogram, electrocardiogram, echocardiography and chest X-ray were helpful to the diagnosis. Antimyocardial antibody participated in the pathogenesy of myocarditis infected by cytomegalovirus, which was one of the important immunological markers.