Lubega S, Zirembuzi G W, Lwabi P
Department of Paediatrics and Child Health, Uganda Heart Institute, Mulago Hospital, Kampala, Uganda.
Afr Health Sci. 2005 Sep;5(3):219-26. doi: 10.5555/afhs.2005.5.3.219.
There are very few published studies of heart disease in HIV infected children living in sub-Saharan Africa, a region with more than 50% of the world's population of HIV infected patients.
To determine the prevalence, and describe the type and clinical presentation of heart disease among children with HIV attending an ambulatory clinic.
Two hundred and thirty (230) HIV infected children attending the Paediatric Infectious Disease Clinic at Mulago hospital were recruited by simple random sampling in a cross-sectional study. The children were evaluated clinically, and investigated by electrocardiography and echocardiography.
Thirty-two children (13.9%) had asymptomatic HIV disease, 156 (67.8%) had AIDS related complex while 42 (18.3%) had AIDS. Heart abnormalities were detected in 51% of the children (40.0% by echocardiography alone and 26.5% by electrocardiography alone). Heart abnormalities were most prevalent in children with AIDS (76.2%) and least prevalent in children with asymptomatic HIV disease (25.0%). The abnormalities included; Sinus tachycardia (21%), left ventricular systolic dysfunction (17%), right ventricular dilatation (14%), congenital heart disease (4.8%), dilated cardiomyopathy (3.0%), pericarditis (2.2%) and cor pulmonale (1.3%). Children with left ventricular systolic dysfunction significantly had easy fatigability, dyspnoea on exertion and tachypnoea. Other heart abnormalities presented with non-specific clinical features.
Heart abnormalities were common especially in children with symptomatic HIV disease and included sinus tachycardia, left ventricular systolic dysfunction and right ventricular dilatation. The detected heart abnormalities, except left ventricular systolic dysfunction, had non-specific clinical features.
在撒哈拉以南非洲地区，针对感染艾滋病毒儿童的心脏病研究发表得极少，而该地区的艾滋病毒感染患者占全球人口的50%以上。
确定在一家门诊就诊的感染艾滋病毒儿童中，心脏病的患病率，并描述其类型和临床表现。
在一项横断面研究中，通过简单随机抽样，招募了230名在穆拉戈医院儿科传染病诊所就诊的感染艾滋病毒儿童。对这些儿童进行临床评估，并通过心电图和超声心动图进行检查。
32名儿童（13.9%）患有无症状艾滋病毒疾病，156名（67.8%）患有艾滋病相关综合征，42名（18.3%）患有艾滋病。51%的儿童检测到心脏异常（仅通过超声心动图检测到的占40.0%，仅通过心电图检测到的占26.5%）。心脏异常在患有艾滋病的儿童中最为普遍（76.2%），在患有无症状艾滋病毒疾病的儿童中最不普遍（25.0%）。异常情况包括：窦性心动过速（21%）、左心室收缩功能障碍（17%）、右心室扩张（14%）、先天性心脏病（4.8%）、扩张型心肌病（3.0%）、心包炎（2.2%）和肺心病（1.3%）。患有左心室收缩功能障碍的儿童明显容易疲劳、运动时呼吸困难和呼吸急促。其他心脏异常表现为非特异性临床特征。
心脏异常很常见，尤其是在有症状的艾滋病毒感染儿童中，包括窦性心动过速、左心室收缩功能障碍和右心室扩张。除左心室收缩功能障碍外，检测到的心脏异常具有非特异性临床特征。
