| Viral myocarditis (VMC) is acute and chronic myocardial inflammation caused by various viral infection, predilection to young adults, the morbidity increasing year by year. Most of VMC can autotherapy, some can deferment or leave arrhythmia, for example, premature contraction,atrial ventricular block, even high degree A-V block, which need permanent artificial heart pacemaker.15%~25% VMC become dilated cardiomyopathy, lead to heart failure or even death. VMC can outbreak prevail in the crowd, where the sanitation condition is very poor, and the climate is moist and warm. VMC is a subtype of infectious cardiomyopathy, which means viral infection injury the myocardium or autoimmune response produce coup injury, also can produce endocardium,pericardium and other organ inflammatory changes, due to some extent heart failure and body symptom.Objective: In order to approach the feature of VMC diagnosis and treatment. Method: we collected and analyzed charts of 334 patiens who had been proved to be VMC by 1999 pediatric VMC diagnostic criteria from 2003.1 to 2007.12 of No.1 Hospital of Jilin university, screen 160 of them who had received ECG,cardial enzyme,cTnI,sternum,color ultrasonography,CVB for the first 24 hours, then received DCG for the first 48 hours, rechecked the abnormal index for 1 week,2 week, 3 week. Divided the patiens into two group to observe the medicine curative effect: control group gave vitaminC,kakkonein, therapy group gave vitaminC,kakkonein and sodium phosphocreatine. Two groups were all bed rest, received antibiotics if there was infection, symptomatic treatment if there was arrhythmia or heart failure. Judge curative effect after course of treatment.Results: In the data, the youngest is 4 months, the oldest is 14 years old, mean age is 6.669±2.118. The infant group is 20, account 12.50%. Spring accouts 33.75%. Herald infection history accounts 61.25%. The symptom of VMC is diversity,polytropy and changeableness, the data show: chest distress accounts 70.63%, deep sigh accounts 55.63%, acratia accounts 46.25%, hidrosis accounts 33.13%, 2 cardiac inadequacy, no cardiac shock or cardio-cerebral syndrome or death. Electrocardiogram of VMC is diversity and polytropy, the data show the masccline ratio is 81.87%, by turns is ST-T,ventricular premature beat,premature atrial contraction,atrial ventricular block. DCG masccline ratio is 86.25%, ECG coadunation DCG s 91.25%. X ray for heart-chest ratio account 10.63%. Color ultrasonography account 13.13%. CK-MB account 60.00%, cTnI account 53.13%. Coadunation masccline ratio is 88.13%, CVB masccline ratio is 30.63%.The data show the control group contrast to the therapy group is notable, there is no adverse effect. The therapy group is better than the control group in ST-T for 1 week, the therapy group is better than the control group in cTnI and CK-MB for 1 week. The therapy group is better than the control group in cTnI and CK-MB for2 week.Conclusions: there is no sex differences in pediatric VMC morbidity, school age account most, spring is predilection season; the most abnormality of ECG is ST-T, next is ventricular premature beat, associate with DCG can extractable diagnostic correctness; CK-MB associate with cTnI extractable diagnostic correctness; On the grounding of conventional therapy, sodium phosphocreatine can action an assisting medicine.
|
PDF Full Text Request