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在儿童中严重心肌炎的增加与帕尔沃病毒B19感染有关:MYKKE注册和德国监测数据

Franziska Seidel¹, Teresa M Nygren², Bernd Opgen-Rhein³

¹Deutsches Herzzentrum der Charité, Department of Congenital Heart Disease-Pediatric Cardiology, Berlin, Germany; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany.

JACC. Heart failure

|January 6, 2026

概括

由于德国的帕尔沃病毒B19 (B19V) 引起的儿科心肌炎急剧增加,特别影响幼儿. 增加的严重程度与年轻的年龄有关,而不是更具毒性的B19V菌株.

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
病毒学病毒学

背景情况:

自2023年8月以来,德国儿科心肌炎病例的增加与帕尔沃病毒B19 (B19V) 的检测增加相吻合.
人们对这种急剧增长的致病因子和有效的对策表示担忧.

研究的目的:

调查帕尔沃病毒B19 (B19V) 与儿科心肌炎增加之间的关联.
评估儿童B19V相关心肌炎的严重程度.

主要方法:

分析了来自27个中心的儿童和青少年心肌炎注册表 (MYKKE) 的数据.
使用PCR阳性和临床/病原学证据定义B19V心肌炎病例.
2013-2023年和2023年8月后病例的临床,遗传病学和流行病学数据的比较,包括当前病例的元基因组和序列分析.

主要成果:

在922名心肌炎患者中,126名 (13.6%) 患有B19V心肌炎;45.2%的当前病例与B19V相关.
目前的B19V心肌炎病例主要影响2岁以下的儿童 (64.9%),在女性中更为常见 (56.1%).
增加的严重程度,以减少喷射分数和更高的B19V病毒载量为指标,与年轻年龄有关,没有证据表明更有毒的B19V菌株 (基因型1A).

结论:

儿科心肌炎的增加与B19V有关,主要是由于受影响的幼儿数量不成比例.
幼儿的脆弱性,而不是一种更具毒性的病毒菌株,解释了观察到的严重性增加.
提高临床意识,积极的跨学科管理和有针对性的预防策略对于这种脆弱的儿科队列至关重要.

关键词:

心脏衰竭是因为心脏衰竭.增加增加增加增加增加增加肌性心肌炎是一种心肌炎.帕尔沃病毒B19 B19 监督监督监督监督监督监督监督监督监督监督监督监督监督监督监督监督监督监督毒性毒性是一种毒性.

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