儿童暴发性心肌炎的诊疗及预后研究进展

摘要

心肌炎是指由各种病因引起的心肌肌层的局限性或弥漫性炎性病变.其中,暴发性心肌炎(FM)又称急性重症病毒性心肌炎,起病急骤,病情变化快,病死率高,预后差.目前,FM的临床诊断方法包括病原学检测、血清生化学指标测定、影像学检查及心内膜心肌活检等.除常规治疗外,在某些情况下FM患儿还需要抗心律失常、抗病毒及免疫调节治疗等.近年来,新开展的医疗技术(体外膜肺、主动脉球囊反搏等)大大降低了FM的病死率.未来,FM患儿治疗中的机械辅助装置将承担重要角色,以最大限度地提高FM患儿的存活率及改善预后.%Myocarditis is a limited or diffusive inflammatory disease of the myocardium caused by a variety of causes. Among them,fulminant myocarditis(FM)is also known as severe viral myocarditis with quick onset,rapid changes in condi-tion,high mortality and bad prognosis.At present,the clinical diagnostic methods include etiological examination,serum biochemical indices,imageological examination and endomyocardial biopsy.In addition to conventional treatment,in some cases,children with FM also need antiarrhythmic,anti-virus,immunomodulatory treatment and so on.Recently,new medical technologies such as extracorporeal membrane oxygenation and intra-aortic balloon pump,have greatly reduced the mortality of FM.In the future,mechanical aids will play an important role in the treatment of children with FM in improving the survival rate and prognosis to the maximum.