Clinical Analysis Of 222 Children With Viral Myocarditis

Objective:To analyze the clinical features of 222 children with viral myocarditis and to investigate the risk factors of children with fulminant myocarditis,and provide reference for early clinical diagnosis and intervention therapy.Methods:A total of 222 patients with childhood viral myocarditis diagnosed from 2012-01 to 2018-1 were included in the fulminant myocarditis group(n=57)and non-fluminant myocarditis group(n=165).The chi-square test or t-test was used.Clinical symptoms and signs,electrocardiogram,echocardiography,and serological examinations were analyzed for the two groups of patients.Statistically significant(P<0.05)relevant indicators were extracted for logistic regression analysis and ROC curve production.Results:In the fulminant myocarditis group,12 patients(21.05%)died.Among them,7 patients died within 1 day of hospitalization.The other 5 patients had no remission during hospitalization and required telephone follow-up after hospital discharge.There was no death in the non-fluminant myocarditis group.Compared with the non-fluminant myocarditis group,the children in the fulminant.Myocarditis group were older and had clinical manifestations of vomiting,decreased appetite,edema,poor peripheral circulation,reduced urine output,convulsions,and disturbance of consciousness.Blood pressure and other more,ECG pathological Q waves,ventricular premature beats,left bundle branch block,ventricular tachycardia,QRS wave prolongation,serological examination Troponin I,brain natriuretic peptide,serum creatinine,urea nitrogen,Alanine aminotransferase,hypokalemia,and Echocardiography revealed more pronounced reductions in left ventricular ejection fraction and shortening of left ventricular short axis(P<0.05).Logistic regression analysis,hypotension(OR=7.248,95% CI=1.352-38.860,P=0.021),left ventricular ejection fraction decreased(OR=63.720,95% CI=8.234-493.115,P=0.000),QRS wave Time course prolongation(OR=1.043,95% CI=1.002-1.085,P=0.039)and age(OR=1.193,95% CI=1.013-1.404,P=0.034)are independent predictors of fulminant myocarditis,LVEF The area under the ROC curve of blood fraction was 0.737(OR=0.000,95% CI=0.641-0.833),and the calculation of the Yoden index yielded a cut-off value of 58.5%,sensitivity of 0.87,specificity of 0.64;and the area under the age curve is 0.725(OR = 0.000,95% CI = 0.649-0.802).The cutoff point value is 3.35 years old,sensitivity.0.84,specificity 0.59.Conclusion : The mortality of fulminant myocarditis is high,and hypotension and left ventricular ejection fraction and QRS wave Time course prolongation and age are independent risk factors.