Salgado Doris M, Panqueba Cesar A, Castro Dolly, R Vega Martha, Rodríguez Jairo A
Facultad de Salud, Universidad Surcolombiana, Neiva, Colombia.
Rev Salud Publica (Bogota). 2009 Aug;11(4):591-600. doi: 10.1590/s0124-00642009000400010.
To determining myocarditis frequency in children suffering from DHF in the Huila region of Colombia.
This was a descriptive and prospective study which was carried out between March 2005 and October 2005 involving 102 patients suffering from DHF, based on WHO criteria. These children were followed-up to identify signs of myocarditis.
10.7 % of the children had signs of myocarditis; one of them was classified as having dengue II and the other ten were classified as suffering form dengue III and IV. This difference was statistically significant (p=0.0004). 10 patients had fulminant myocarditis and required early inotropic support. Two patients had tachyarrythmias in the EKG (one SV and one ventricular); the others had sinusal bradichardia and low voltages. Echocardiograms were perfomed on 50 % of the children, revealing pericardial leakage grade I and II in two patients, one with very diminished EF and AF. Average hospital stay was 7 days. 10 had satisfactory outcome whereas one died.
This series of cases in children reinforces the association between myocarditis and dengue viral infection.
确定哥伦比亚惠拉地区患登革出血热儿童的心肌炎发病率。
这是一项描述性前瞻性研究,于2005年3月至2005年10月期间开展,基于世界卫生组织标准纳入了102例登革出血热患者。对这些儿童进行随访以确定心肌炎迹象。
10.7%的儿童有心肌炎迹象;其中1例被归类为登革热Ⅱ型,另外10例被归类为登革热Ⅲ型和Ⅳ型。这种差异具有统计学意义(p = 0.0004)。10例患者患有暴发性心肌炎,需要早期给予强心支持。2例患者心电图出现快速心律失常(1例室上性和1例室性);其他患者有窦性心动过缓和低电压。50%的儿童进行了超声心动图检查,发现2例患者有Ⅰ级和Ⅱ级心包积液,其中1例射血分数极低且伴有房颤。平均住院时间为7天。10例预后良好,1例死亡。
该系列儿童病例强化了心肌炎与登革病毒感染之间的关联。