小儿急性心肌梗死样重症心肌炎临床分析  

Clinical manifestation and prognosis of the children with acute myocardial infarction-like acute severe myo carditis

作　　者：芮涛[1] 王雪娣[1] 曹勤[1] 李蔚[1] 

机构地区：[1]同济大学附属东方医院儿科,上海200120

出　　处：《小儿急救医学》2005年第2期129-131,共3页Pediatric Emergency Medicine

摘　　要：目的探讨小儿急性心肌梗死样重症心肌炎临床表现及预后。方法回顾性分析4例心电图有类似急性心肌梗死时ST T改变,心肌酶谱异常增高,误诊为“急性心肌梗死”患儿的病史、心电图、心肌酶谱、心律失常、心功能不全等临床表现。结果4例患儿入院时均误诊为“急性心肌梗死”。2例并发III度房室传导阻滞,其中1例出现阿斯综合征,抢救无效死亡。1例窦性心动过速误诊为室性心动过速而应用电复律死亡。1例出现心源性休克。结论当急性重症心肌炎患儿心电图、心肌酶谱出现急性心肌梗死样改变时,病情凶险,病死率极高。要结合既往史、临床表现及时作出正确诊断和处理。Objective To explore the clinical manifestation and prognosis of acute severe childhood myocarditis which presenting as acute myocardial infarction.Methods we retrospectively analysedthemedical histories、ECG and myocardial enzyme in 4 cases which is similar to acute myocardial infarction.Results The 4 cases were all misdiagnosed as acute myocardial infarction.Two of them were complicated with III° A-V block,1 of them died of Adams-Stokes attack and 1 died of electrical cardioversion for misdiagnosed ventricular tachycardia.Mortality was up to 50%.One occurred cardiogenic shock.Conclusion Clinical manifestation in acute severe childhood myocarditis presenting as acute myocardial infarction have ferocious state of illness and mortality is very high.Correct diagnosis should be made by analyzing past-history and clinical manifestation in time.

关 键 词：小儿 重症心肌炎 

分 类 号：R725.4[医药卫生—儿科]