病毒性心肌炎(VMC)的临床特点是病情轻重悬殊,缺乏特异性表现,常造成诊断困难.心肌钙蛋白-I(cTnI)属心肌结构蛋白,具有特异的抗原性.为探讨其在小儿VMC诊断中的价值,自1998年起进行了临床研究,报告如下.

目的:了解我院10年来风湿热(RF)患儿住院人数变化并分析其心脏受累情况.方法:回顾性统计10年RF患儿每年住院人数并进行比较,分析RF患儿心脏受累情况、分析指标包括心脏体检、超声心动图、心电图、心肌酶谱.结果:90年-99年RF患儿住院率明显下降,99年住院病人为90年的15.38%,全部60例RF患儿中45例心脏有不同程度受累,占75%.结论:①间接反映我省儿童RF发病率呈下降趋势;②儿童RF心脏受累突出,应高度重视RF对心脏的损害.

患儿,女,2a6mo.因发热7h、抽搐2h入院.曾在la时有过一次晕厥史.查体:T39C,中度昏迷,口唇轻度紫绀,双肺可闻及干鸣音.心率97次/min,律不齐,心音有力,未闻及杂音.心电监护示窦性心律,室性早搏,T波异常.抽搐发作时为尖端扭转型室性心动过速(Tdp).ECG:QT间期延长,T波普遍倒置或双向,可见异常U波.测得QT、校正QT间期(QTc)、QT离散度(QTd)、校正QT离散度(QTcd)分别为480ms、611ms、140ms、178ms.血钾3.8 mmol/L,钠130mmol/L,钙2.13mmol/L.胸片报告支气管肺炎,心外形不大.诊断为先天性QT间期延长综合征(LQTS)并Tdp,支气管肺炎.予补钾、静注利多卡因后改为静脉点滴维持用药,效差,静脉补镁也无效,改为口服心得安30mg/d,分3次,Tdp控制,测得QT、QT.QTd、QTcd分别为440ms、455ms、35ms、36ms.

Objective: To evaluate the clinical effect of Shenmai injection (SMI) on infantile viral myocarditis.Methods: Fifty patients were treated with SMI combined with routine Western medicines, the effects were observed and compared with those treated with Western medicines alone or compound Salviae liquid.Results: The cardiac function and cellular immunity of patients treated with SMI were significantly improved. The effect of SMI was superior to that of control groups.Conclusion: Using SMI as supplementary treatment in treating infantile viral myocarditis was helpful in recovery of cardiac function and cellular immunity.