| Objective:To improve the diagnosis and treatment of acute fulminant myocarditis(AFM)and to lay the foundation for the large-scale randomized controlled trials, we retrospectively analysed the data of 67 patients admitted to our department. the clinical characteristic,diagnosis,treatment methods, short outcome were summarized.Method:The retrospective study analysed the data of 67 cases of AFM in children admitted to our department from february 2005 to september2015. the general condition, clinical manifestation, physical examination,laboratory findings, thera-peutics and short outcomes were involved.Besides,the SPSS16.0 was used for statistical analysis.Results:1.A total of 67 cases were included in our study,31 cases were males,36 were females. Median age was 6 year and 1month.2.Most of the patients(83.6%) had prodromic infection,the main complications were heart failure(59.7%), Adams-Stokes syndrome(38.8%),cardiogenic shock(29.8%), High grade atrial ventricular block(26.9%),sustained ventricular tachycardia(19.4%) and respiratory failure(20.1%)。3.The positive rate of serum Creatine kinase isoenzyme(CKMB) is87%,which is higher than thatof c Tn. The most common viral pathogen of AFM is CBV. High grade atrial ventricular block(AVB) was the most common performance(29.0%).About 92.3% of echocardiogram were abnormal, cardiac chamber enlargement,valvular regurgitation,decrease of left ventricular ejection fraction were most common.4. The recovery rate of using gulcocorticoid(69.2%) is significantly higher than that without using(16.7%) P<0.05.The recovery rate of combined using gulcocorticoid and IVIG(86.4%) is also higher than without IVIG(56.7%) P<0.05.Conclusion:The early clinical manifestation of AFM in children is not typical.it’s difficult to diagnose,rapid progressing,with the high mortality.And may be associated with heart failure,Adams-Stokes syndrome,cardiogenic shock.The aggressive use of gulcocorticoid, IVIG and Symptomatic treatment may reduce the mortality of children. |
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