Department of Cardiology, Xuzhou Children's Hospital, Xuzhou, Jiangsu, P. R. China.
Eur Rev Med Pharmacol Sci. 2017 Jul;21(13):3083-3087.
To analyze the correlation between chronic viral myocarditis (CVMC) in children, complicated with arrhythmia and thyroid hormone level.
60 patients with CVMC complicated with arrhythmia were continuously selected (course of disease > 3 months) and they are were diagnosed with arrhythmia by the routine 18-lead electrocardiogram and 24-hour Holter; the average follow-up time is about 2 years, during which the left ventricular end-diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), the occurrence rate of malignant arrhythmia events, immune state of T cell and thyroid hormone level (FT3, FT4, TSH, TGAb and TPOAb) were compared.
Among the selected 60 patients, 18 patients (30.0%) who were suffering from malignant arrhythmia have been taken as the observation group. When compared with the control group, the standard deviation normal to normal intervals (SDNN), LVEF, CD4 and CD4/CD8 were reduced and LVEDd and CD8 were increased in the observation group; the difference has statistical significance (p < 0.05). When compared with the control group, FT3 and FT4 are significantly reduced and TSH, thyroglobulin antibody TGAB and thyroid peroxidase antibodies (TPOAb) are significantly increased; the difference has statistical significance (p < 0.05). According to the logistic regression analysis, we can conclude that: SDNN, FT3, FT4, TSH, TGAb and TPOAb are the independent risk factors of malignant arrhythmia (p < 0.05).
Thyroid hormones and antibody level are helpful to the prognosis of malignant arrhythmia resulting from children chronic VMC complicated with arrhythmia complications.
分析儿童慢性病毒性心肌炎（CVMC）并发心律失常与甲状腺激素水平的相关性。
连续选取 60 例 CVMC 并发心律失常患儿（病程>3 个月），常规 18 导联心电图及 24 小时动态心电图诊断为心律失常；平均随访时间约 2 年，比较左心室舒张末期直径（LVEDd）、左心室射血分数（LVEF）、恶性心律失常事件发生率、T 细胞免疫状态及甲状腺激素水平（FT3、FT4、TSH、TGAb 和 TPOAb）。
在入选的 60 例患儿中，18 例（30.0%）发生恶性心律失常者作为观察组，与对照组比较，观察组的标准差正常到正常间期（SDNN）、LVEF、CD4 和 CD4/CD8 降低，LVEDd 和 CD8 升高，差异有统计学意义（p<0.05）；FT3、FT4 降低，TSH、甲状腺球蛋白抗体（TGAb）和甲状腺过氧化物酶抗体（TPOAb）升高，差异有统计学意义（p<0.05）。经 logistic 回归分析，SDNN、FT3、FT4、TSH、TGAb 和 TPOAb 是恶性心律失常的独立危险因素（p<0.05）。
甲状腺激素及抗体水平有助于判断儿童慢性 VMC 并发心律失常所致恶性心律失常的预后。
