摘要
目的探讨不同类型手足口病(HFMD)患儿心功能的变化情况。方法选取2009年3—9月临沂市人民医院儿科收治的HFMD患儿78例,根据病情分为HFMD组25例,脑干脑炎组20例,肺出血组19例,恢复组14例,另选取正常婴幼儿20例为正常组。采用二维多普勒超声测量左室内径(LVD)、右室内径(RVD)、左房内径(LA)、左室后壁厚度(LVPWT)、室间隔厚度(IVST)、主动脉内径(AO)及肺动脉内径(PA),同步描记心电图,计算心率(HR)、每搏输出量(SV)、心排血量(CO)、心脏指数(CI)。结果正常组、HFMD组、脑干脑炎组、肺出血组及恢复组LVD、RVD、LA、LVPWT、IVST、AO及PA比较,差异均无统计学意义(P>0.05)。5组HR、SV、CO、CI比较,差异均有统计学意义(P<0.05);其中肺出血组与正常组、HFMD组、脑干脑炎组、恢复组上述指标比较,差异均有统计学意义(P<0.05)。肺出血组患儿中,死亡的7例CI为(2.03±0.28)L.min-1.m-2,存活的12例为(2.45±0.27)L.min-1.m-2,差异有统计学意义(t=3.1910,P<0.05)。以CI低于参考值的下限2.5 L.min-1.m-2为准,HFMD患儿不同类型与CI降低率间,差异有统计学意义(P<0.0001)。结论重症HFMD患儿存在一过性CI降低,肺出血组死亡患儿的CI较存活患儿明显降低,CI测定对评价HFMD患儿的心脏功能及估测预后有一定价值。
Objective To observe the alterations of cardiac output （CO） in patients with hand - foot - mouth disease （HFMD） and to explore their relationship with clinical manifestations. Methods 78 HFMD infants admitted to Linyi People＇s Hospital from March to September in 2009 were divided into HFMD group （25 cases）, brainstem encephalitis group （20 ca- ses）, pulmonary hemorrhage group （19 cases） and recovery group （14 cases）. 20 healthy infants were selected as control group. Two - dimensional and Doppler echocardiography was used to detect LVD, RVD, LA, LVPWT, IVST, AO and PA. Meanwhile, electrocardiogram was recorded and HR, SV, CO and CI were calculated. Results The LVD, RVD, LA, LVP- WT, IVST, AO and PA among control group, HFMD group, brainstem encephalitis group, pulmonary hemorrhage group and recovery group showed no statistically significant differences （ P 〉 0.05 ）, but HR, SV, CO and CI among the five groups showed statistically significant differences （P 〈 0. 05）. Compared with control group, HFMD group, brainstem encephalitis group and recovery group, the HR, SV, CO and CI in pulmonary hemorrhage group showed statistically significant differences （P 〈0. 05）. In the pulmonary hemorrhage group, the CI of the 7 died cases was （2.03 ±0. 28） L .min-1.m-2, while in the 12 survived cases was （2.45 ± 0. 27） L . rain-1 . m-2, and the difference was statistically significant （ t = 3. 1910, P 〈 0. 05）. The CI reduction rate of the four groups showed statistically significant differences after taking CI lower than 2. 5 L .m-1.m-2m as criteria （P 〈 0. 0001）. Conclusion Severe HFMD infants have transient low cardiac output, and the CI of pul- monary hemorrhage group is significantly decreased than survived cases. The detection of CI is of good significance for the evalua- tion of cardiac function and prognosis.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第5期490-492,共3页
Chinese General Practice
关键词
手足口病
心排血量
每搏输出量
Hand, foot and mouth disease
Cardiac output
Stroke volume
