儿童急性暴发性心肌炎诊治进展

急性暴发性心肌炎(acute fulminant myocarditis,AFM)起病急骤,可在短期内进展为心力衰竭与心源性休克而致死.儿童AFM早期诊断困难,临床首发以心外消化道与呼吸系统症状多见,主要表现为腹痛、呕吐、咳嗽、气促等,易误诊与漏诊.新型的心肌损伤标志物和心肌磁共振成像技术在早期诊断AFM有一定的临床价值.紧急床旁临时心脏起搏、体外膜肺氧合和床旁连续血液净化等生命支持技术的发展降低了儿童AFM的病死率.

Advancements in diagnosis and treatment of pediatric acute fulminant myocarditis

Acute fulminant myocarditis( AFM) is characterized by abrupt onset of severe congestive heart failure followed by severe haemodynamic deterioration,sometimes resulting in death. Early diagnosis of AFM is challenging due to its myriad of presentations,gastrointestinal tract and respiratory system symptoms including vomiting,abdominal pain,cough and respiratory distress were more frequent than cardiopulmonary symptoms. New myocardial biomarkers and cardiovascular magnetic resonance imaging have become useful for early diagnosis of AFM. Emergency bedside temporary cardiac pacing,extracorporeal membrane oxygena-tion and continuous renal replacement therapy may reduce the mortality of AFM in children.