在儿童患者中高胆固醇血性膜病变和严重动脉样硬化
Karthik Gopinath1, Gayathri Bhuvaneswaran Kartha1, Ravi Sankar Tulluru1
1Department of Cardiology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
Cardiology in the young
|September 22, 2025
概括
早期儿童动脉样硬化,虽然很少见,但可以导致严重的心血管变化,包括关节的参与. 积极的降脂疗法对于治疗儿童这种疾病至关重要.
科学领域:
- 心血管医学 心血管医学
- 儿童心脏病学 儿童心脏病学
- 血管生物学 血管生物学
背景情况:
- 动脉样硬化是血管疾病的主要原因,传统上影响的是老年人,但起源于童年.
- 高水平的动脉动脉风险因素可以在儿童中导致冠状动脉疾病 (CAD).
- 冠状动脉疾病在幼儿中不常见,通常与川崎病或先天性异常有关;由于高胆固醇血症而导致的 mitra 膜干扰特别罕见.
研究的目的:
- 调查动脉样硬化冠状动脉疾病的儿科病例,包括膜干扰.
- 阐明在儿科动脉样硬化中膜参与背后的机制.
- 突出这一群体内家族高胆固醇血症的诊断和治疗挑战.
主要方法:
- 从2005年1月到2024年7月进行冠状动脉血管造影的儿童 (<14岁) 的回顾性审计.
- 纳入标准:诊断为动脉样硬化冠状动脉疾病.
- 分析的重点是同时出现膜干扰的病例.
主要成果:
- 确定了四例患有动脉样硬化冠状动脉疾病的儿科病例,其中包括膜干扰.
- 尽管正在进行降脂治疗,但发生了膜干扰.
- 突出了膜参与的机制和家族高胆固醇血症管理中的挑战.
结论:
- 这些病例表明,在儿科动脉样硬化中,心血管系统发生了显著的变化.
- 早期识别和积极的降脂疗法对于治疗儿科动脉样硬化心血管疾病至关重要.
- 及时开始治疗对于改善严重高胆固醇血症和动脉样硬化症儿童的治疗结果至关重要.
相关概念视频
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
195
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
195
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
212
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
212
01:26Mitral Stenosis III: Medical Management
247
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
247
01:26Atherosclerosis III: Management
322
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
322
01:28Esophageal Varices-II: Clinical Features and Management
376
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
376
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
254
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
254