糖皮质激素和静脉丙种球蛋白在重症心肌炎救治中的应用进展

被引：14

作者：

张清友

杜军保

机构：

[1] 北京大学第一医院儿科

来源：

中国小儿急救医学 | 2013年 / 20卷 / 05期

关键词：

心肌炎; 治疗; 儿童;

D O I：

暂无

中图分类号：

R725.4 [小儿心脏、血管疾病];

学科分类号：

摘要：

心肌炎是儿科最常见的获得性心血管疾病之一,也是导致小儿扩张型心肌病最常见的病因,但其诊治一直是心血管领域的难题。近期的小儿心肌病注册研究发现,大多数小儿心肌炎的心脏功能能恢复正常,但是仍有30%左右的患儿死亡或需要心脏移植。动物实验和成人经验表明自身免疫反应是心肌炎导致心功能不全的主要原因。免疫抑制剂治疗和静脉丙种球蛋白的免疫调节治疗在小儿心肌炎中的作用仍具有争论。部分少数病例研究发现以糖皮质激素为主的免疫抑制剂治疗及静脉丙种球蛋白的免疫调节治疗对小儿重症心肌炎有益,但并非所有病例会获益,甚至对部分患者还有害。通过临床研究发现治疗有效患儿的临床特征,并进一步通过多中心随机对照研究验证这些特征,可能是我国小儿重症心肌炎临床研究的合理途径。

引用

页码：459 / 463

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