发性心肌炎儿童的死亡率:一项为期六年的多中心回顾性研究
Lijun Yang1, Wenting Zhao1, Xuming Mo2
1Department of Heart Failure and Mechanical Circulatory Support, Heart Institute, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.
Annals of intensive care
|March 6, 2026
概括
早期识别高风险的儿科发性心肌炎 (FM) 是至关重要的. 乳酸酸峰值,CK-MB和心室低心率预测死亡率,支持后持续的高乳酸水平表明风险增加.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 关键护理医学 关键护理医学
- 疾病中的生物标志物.
背景情况:
- 儿童的发性心肌炎 (FM) 可以迅速导致心脏性休克和死亡.
- 预后标志物的早期识别对于及时的循环支持至关重要.
- 这项研究旨在确定儿科FM.医院住院死亡率的早期预测因素.
研究的目的:
- 描述儿科FM的临床特征.
- 确定儿科FM.医院住院死亡率的早期预测因素.
- 评估特定生物标志物和临床事件的预后价值.
主要方法:
- 儿童 FM 患者 (<18 岁) 的回顾性队列研究,这些患者被录取到具有 ECMO 能力的 PICU.
- 对临床,生化,心电图和心声学变量的分析.
- 后勤回归和ROC曲线分析以确定死亡率预测因素.
主要成果:
- 包括187名儿童;医院死亡率为16.6%.
- 升高的CK-MB,乳酸峰值和心室性心力衰竭与死亡率有关.
- 乳酸峰值和CK-MB是独立的预测因素;包括CK-MB,乳酸峰值和VT在内的复合模型具有最好的预测性能 (AUC0.815).
结论:
- 乳酸峰值,CK-MB和心室低心率是儿科FM中死亡率的早期独立预测因素.
- 在先进支持后12小时内持续的高乳糖血症增加了预后价值.
- 这些标记物有助于在儿科 FM 患者的早期风险分层.
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