肌心炎的特征:COVID-19后儿童的形态差异诊断
Vadim Karev1,2, Anastasia Ya Starshinova3, Anzhela Glushkova4
1Children's Clinical Research Center for Infectious Diseases, St. Petersburg 194100, Russia.
Diagnostics (Basel, Switzerland)
|August 12, 2023
概括
诊断心肌炎,特别是来自SARS-CoV-2感染,需要重新考虑PCR以外的形态学标准. 组织病理学变化为儿童和成人这种心血管炎症提供了关键标志物.
科学领域:
- 心脏病学 心脏病学
- 病理学 病理学 病理学
- 传染性疾病 传染性疾病
背景情况:
- 心肌炎涉及心肌细胞功能障碍,炎症和纤维化,构成全球健康挑战.
- 肌心炎的晚期诊断是一个重大问题,由新型冠状病毒感染如COVID-19所加剧.
- 了解病毒病因,包括SARS-CoV-2,对于准确的心肌炎诊断至关重要.
研究的目的:
- 用仪器和病态学发现来区分病毒病因的心肌炎,特别是SARS-CoV-2.
- 审查和分析与病毒感染有关的心肌炎的诊断标准.
主要方法:
- 从2019年12月到2023年5月对出版物的系统审查.
- 在主要的国际数据库 (Medline,PubMed,Scopus) 进行了搜索.
- 关键词包括:心肌炎,儿童,心血管炎症,COVID-19,SARS-CoV-2和差异诊断.
主要成果:
- 没有确定SARS-CoV-2相关心肌炎的最终形态标准.
- 针对SARS-CoV-2感染的关键组织病理标志物包括与病毒相关的退化,亡,心肌细胞亡,高血压,胀和毛细血管内皮功能障碍.
- 这些发现突显了SARS-CoV-2感染期间心肌组织的特定变化.
结论:
- 仅仅依赖病毒RNA的PCR是诊断SARS-CoV-2心肌炎的不足;形态标准需要重新评估.
- 与其他病毒感染相关的肌心炎存在类似的诊断挑战.
- 病因诊断需要全面的方法:确认病毒暴露,临床症状,成像 (MRI/CT) 和形态数据.
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