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目的:探讨小儿病毒性心肌炎(VMC)与扩张型心肌病(DCM)的不同临床特征。方法:对63例小儿 VMC和23例小儿DCM的临床资料进行对比分析。结果:与VMC相比,DCM患儿发病年龄在2岁以下者 (4.3%)少见,病程较长(>2个月者占61.0%),心脏增大和心力衰竭发生率高(均P<0.05),心脏增大明显,中 重度二尖瓣反流(82.6%)多见,心力衰竭较严重,心脏收缩功能减退显著(P<0.05);与DCM相比,VMC患儿 多有新近病毒感染史(79.4%),血清病毒 IgM阳性(77.1%)及CK MB升高(77.8%)(均P<0.05),治疗3个月 后VMC患儿轻度增大的心脏恢复正常。结论:小儿VMC与DCM在发病年龄、病程、有无新近病毒感染史,CK MB升高、心脏增大、心力衰竭和心脏收缩功能减退的发生率及程度,治疗效应方面均有不同,但两者的差异是相 对的,必须综合判断才能做出正确诊断,其中超声心动图和治疗效应对鉴别诊断尤为重要。
Objective: To investigate the different clinical features of viral myocarditis (VMC) and dilated cardiomyopathy (DCM) in children. Methods: The clinical data of 63 pediatric VMCs and 23 pediatric DCMs were compared and analyzed. Results: Compared with VMC, the incidence of DCM in children younger than 2 years (4.3%) was rare, the course was longer (61.0% for> 2 months), heart enlargement and heart failure were higher (all P <0.05 ), The heart increased significantly, moderate to severe mitral regurgitation (82.6%) more common, severe heart failure, cardiac systolic dysfunction was significantly (P <0.05); compared with DCM, VMC children more recent virus infection (79.4%), serum IgM positive (77.1%) and elevated CK MB (77.8%) (all P <0.05). After 3 months of treatment, the slightly enlarged heart in VMC returned to normal. Conclusion: The incidence and extent of VMC and DCM in pediatric patients are different in terms of age of onset, duration of disease, presence or absence of recent virus infection, elevated CK MB, increased heart rate, heart failure and cardiac systolic dysfunction, and therapeutic effect The difference is relative, we must make a comprehensive judgment to make the correct diagnosis, of which echocardiography and therapeutic effect of differential diagnosis is particularly important.