Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Pediatr Neonatol. 2011 Jun;52(3):135-9. doi: 10.1016/j.pedneo.2011.03.005. Epub 2011 May 31.
The purposes of this study were to characterize the symptoms and signs of children with myocarditis at the time of presentation to the hospital and to identify the predictors of death.
This was a 5-year retrospective study in a tertiary hospital. We collected demographic data and clinical symptoms and signs when children with myocarditis presented at the hospital. The outcome for patient was classified as either survival or death, and the predictors of death were identified.
Over the 5-year period, 27 children (14 boys and 13 girls) met the definition of clinical myocarditis. The mean age of the myocarditis patients was 9.1±5.1 years (range, 0.08-17.9 years), and the maximum age was 10-12 years. The most common presentation was gastrointestinal symptoms. We used extracorporeal membrane oxygenation on nine (33%) children, and pacemaker was implanted in eight (30%). Six (22%) children died in this study, and only one of them was younger than 6 years. The poor prognosis predictors were gastrointestinal symptoms, hepatomegaly, and hypotension.
Pediatric myocarditis presents primarily with gastrointestinal symptoms in Taiwan. Careful check of heart rhythm may provide a useful objective marker of myocarditis. The predictors of a poor prognosis were gastrointestinal symptoms, hepatomegaly, and hypotension.
本研究旨在描述儿童心肌炎在就诊时的症状和体征，并确定死亡的预测因素。
这是一家三级医院进行的 5 年回顾性研究。我们收集了心肌炎患儿就诊时的人口统计学数据和临床症状及体征。将患者的结局分为存活或死亡，并确定死亡的预测因素。
在 5 年期间，27 名儿童（14 名男孩和 13 名女孩）符合临床心肌炎的定义。心肌炎患者的平均年龄为 9.1±5.1 岁（范围：0.08-17.9 岁），最大年龄为 10-12 岁。最常见的表现是胃肠道症状。我们对 9 名（33%）儿童使用了体外膜肺氧合，对 8 名（30%）儿童植入了起搏器。在这项研究中，有 6 名（22%）儿童死亡，其中只有 1 名年龄小于 6 岁。预后不良的预测因素是胃肠道症状、肝肿大和低血压。
台湾的小儿心肌炎主要表现为胃肠道症状。仔细检查心律可能为心肌炎提供有用的客观标志物。预后不良的预测因素是胃肠道症状、肝肿大和低血压。
