小儿扩张型心肌病的治疗和预后研究  

A study on prognosis and treatment of dilated cardiomyopathy in pediatric patients

作　　者：李运泉[1] 陈国桢[1] 王慧深[1] 覃有振[1] 李淑娟[1] 李格丽[1] 

机构地区：[1]广州中山大学附属第一医院心血管儿科,510080

出　　处：《中国临床实用医学》2008年第9期53-55,共3页China Clinical Practical Medicine

摘　　要：目的探讨小儿扩张型心肌病（DCM）的预后和静脉用丙种球蛋白（Wm）治疗小儿DCM的疗效。方法对34例小儿DCM患者的临床资料和随访结果进行分析，按治疗方法分成常规应用洋地黄、利尿剂及血管紧张素转换酶抑制剂（ACEI）治疗的常规治疗组和在常规治疗基础上加用大剂量WIG治疗的IVIG治疗组。采用SPSSl3．0软件包寿命表法和Kaplan—Meier法进行生存分析和两种治疗方法疗效比较分析。P〈0．05为差异有统计学意义。结果常规治疗组16例：男10例，女6例，平均7．8岁（7月～14岁）。IVIG治疗组18例：男11例，女7例，平均7．5岁（9月一12岁）。本组DCM患者死亡8例（23．5％），确诊并治疗后5年生存率为48％，IVIG治疗组的5年生存率为64％。生存分析显示IVIG治疗组较对照组能延长患者生存时间和减少臆用血管活性药物及住院次数（P〈0．05）。结论小儿DCM预后不佳，应用大剂量IVIG治疗有助于改善其预后。Objective To assess the prognosis of dilated cardiomyopathy（DCM） in children and to e- valuate the effect of IVIG on pediatric patients with DCM. Methods 34 patients were enrolled, and they were divided into conventional treatment group and IVIG group （conventional treatment plus large dose IVIG） . Sta- tistical analysis were carried out in SPSSI3.0 software. Life table and Kaplan - Meier analysis were used to ana- lyze the survival and the comparison of treatment effect between two groups. P 〈 0.05 is statistically significant. Results Conventional treatment group had 16 cases（ male 10 and female 6） aged from 7 month to 14 years old （ median 7.8 years） , and [VIG group had 18 cases （ male 11 and female 7 ） aged from 9 month to 12 years old （median 7.5years） . From the enrolled patients were diagnosed and treatment, 8 patients （23.5%）died and five - year survival rates was 48%, while five-year survival rates was 64% in IVIG group. Analysis of survival display survival time of patients in IVIG group was longer than that of patients in conventional treatment group, both application of vasoactive agents and hospitalization times were fewer in IVIG group than those of patients in conventional treatment group （ P 〈 O. 05 ）. Conclusion The prognosis of DCM in pediatric patients is not good. Application of large dose IVIG is beneficial to the patients with DCM in children.

关 键 词：心肌病 扩张型 小儿 静脉用丙种球蛋白 预后 生存分析 

分 类 号：R725.4[医药卫生—儿科]