疑似病毒性心肌炎患儿频发房性期前收缩41例近期随访研究  

The short-term follow-up of the frequent atrial premature contraction in suspected viral myocarditis children

作　　者：马兰芳[1] 安金斗[1] 冯嵩[1] 葛薇[1] 

机构地区：[1]郑州大学第一附属医院小儿内科,河南郑州450052

出　　处：《中国实用儿科杂志》2014年第9期691-695,共5页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨疑似病毒性心肌炎患儿频发房性期前收缩的特点及近期预后。方法收集郑州大学第一附属医院儿科10年来收治的以频发房性期前收缩为主要临床表现的41例疑似病毒性心肌炎患儿临床资料,回顾性分析其动态心电图特点及房性期前收缩的近期预后,并探讨两者的关系。结果 (1)30例(73%)全天房性期前收缩总数小于20000,4例(10%)为房性并行心律,35例(85%)心房异位P'波可提前至T波,14例(32%)合并房性心动过速,多数病例为单源性期前收缩、起源于心房下部。(2)给予2周抗病毒、营养心肌、抗氧化及中成药治疗后,半数患儿房性期前收缩减少超过30%。(3)合并房性心动过速者比单纯频发房性期前收缩者近期预后好(P<0.05)。结论疑似病毒性心肌炎儿童的频发房性期前收缩,尤其是合并房性心动过速者,多为病毒性心肌炎引起,按病毒性心肌炎治疗可使期前收缩减少或消失。Objective To investigate the features and short-term prognosis of the frequent atrial premature contraction in suspected viral myocarditis children. Methods We collected 41 suspected viral myocarditis patients admitted by the Pediatric Department of our hospital during the latest 10 years, whose main manifestations were frequent atrial premature contraction, and then analysed their Hoher, short-term prognosis and the relationship between the two. Results （l） There were 30 cases （73%） whose total atrial premature contractions in the Holter were below 20000; 4 cases （10%） were atrial pararrhythmia, 35 cases （85%） with the atrial ectopic P＇ wave merged into T wave, 14 cases （32%） coexist- ed with atrial tachyeardia ; most premature contractions were monophyletic and originated from the lower part of the atria. （2） After 2 weeks of antivirus, myocardial nutrition, antioxidant treatment and traditional Chinese medicine therapy, the premature contraction decreased more than 30% in half of the patients. （3）The premature contraction decreased more re- markably in patients with atrial tachycardia than those with pure atrial premature contraction. Conclusion For the fre- quent atrial premature contraction in suspected viral myocarditis children, especially for those coexisted with atrial taehy- cardia, the most common reason is viral myocarditis, and the atrial premature contranction could decrease or disappear af- ter treatment based on this diagnosis.

关 键 词：疑似病毒性心肌炎 频发房性期前收缩 房性心动过速 动态心电图 近期随访 

分 类 号：R72[医药卫生—儿科]