心肌炎所致小儿完全性房室传导阻滞17例临床分析

目的分析感染性心肌炎所致小儿完全性房室传导阻滞(CAVB)的临床特点及治疗，以提高对该病的认识。方法对1984-08—2005-03上海市交通大学附属儿童医院收治的感染性心肌炎所致CAVB17例进行回顾性分析。结果17例CAVB患儿出现阿斯综合征者8例，心功能不全者5例。17例胸片检查心影增大13例。13例心脏超声检查示均有左心室增大。心电图示平均心室率为(528±104)/min。急重症心肌炎6例，均予甲基泼尼松龙静脉冲击和营养心肌治疗，3例安置临时起搏器进行治疗;其余患儿都以改善传导、增快心室率药物治疗。治愈6例，好转5例，仍为CAVB 5例，死亡1例。结论急重症心肌炎发生CAVB可以是致命的，如果能早期诊断、及时应用大剂量肾上腺皮质激素及给予急诊临时起搏器处理，将会取得较好的预后。在随访心肌炎所致房室传导阻滞患儿时，如并有束支传导阻滞者、QRS波增宽、结性逸搏时要高度警惕其可能进展为CAVB。

Complete atrioventricular block resulted from myocarditis in 17 children.

Objectives To screen the infection status of human papillomavirus (HPV) in outpatient women. Methods A total of 2285 outpatient women were checked for 21 HPV DNA types by DNA flow-through hybridization genotyping technique. Results All of the 21 types HPV were detected: the HPV-positive rate was 57.1% (1305/2285),and the overall prevalence of high-risk, low-risk and the multiplex HPV infection was 41.0%, 7.2% and 8.9%, respectively. HPV 16 was the most common type,and the other common types, in descending order of frequency, were type 58, 52, 53, 33, 6, CP8304, 11, 31 and 18. The prevalence of HPV infection peaked in the 30~34 years old (11.3%) and then gradually declined, reaching a level of 7.6% for women in the 40~44 years old. There was significant difference in the HPV-positive rates among each age group (P<0.01). Conclusion Our study shows that the prevalence of HPV infection is 57.1% in outpatient women. The common types of HPV infection are 16, 58, 52, 53, 33, 6, CP8304, 11, 31 and 18. The HPV infection peak age is 30~34 years old.