在MIS-C的基线心声学和实验室发现以及与临床疾病严重程度的关联
Matthew Beaver1,2, Bryan Jepson3, Edem Binka3
1Department of Pediatrics, Division of Pediatric Cardiology, University of Utah, Salt Lake City, UT, USA. matthew.beaver@hsc.utah.edu.
Pediatric cardiology
|January 28, 2024
概括
近一半患有多系统炎症综合征 (MIS-C) 的儿童需要血管活性药物治疗. 升高的C-反应蛋白和入院时的左下心室喷射分数预测了MIS-C的严重程度.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 可能导致严重疾病,包括心脏并发症.
- 识别疾病严重程度的早期指标对于及时干预至关重要.
- 心声学和实验室参数是评估MIS-C严重性的潜在标志物.
研究的目的:
- 调查初始心声和实验室检测结果与MIS-C严重程度之间的关联.
- 确定这些参数是否可以预测需要血管活性药物的需要,这是严重疾病的标志物.
主要方法:
- 在2020年4月至2021年12月期间入院的118名MIS-C患者的回顾性研究.
- 排除标准包括先前存在的心脏病或心脏毒性治疗.
- 使用后勤回归模型来评估入院参数与血管活性药物使用之间的关系.
主要成果:
- 48%的MIS-C患者接受了血管活性药物.
- 更高的摄入脑尿性,C-反应蛋白,素和左下心室喷射分数 (LVEF) 和左心房储菌株与血管活性药物使用有关.
- 独立显著的预测因素是较高的C反应蛋白 (CRP) 和较低的LVEF.
- 即使在接受LVEF正常的患者中,CRP升高和脑性尿素 (BNP) 也预测了血管活性药物的使用.
结论:
- 系统性炎症 (CRP) 和心脏损伤 (BNP,热素) 的实验室标志物与LVEF一起,对于评估MIS-C严重程度很重要.
- 入院心声谱菌株参数对疾病严重程度没有歧视性影响.
- 炎症和心脏生物标志物可能更可靠地用于早期预测需要血管活性支持的严重MIS-C.
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