儿童心肌损伤及心肌炎诊治中的几个临床热点问题
Several clinical hotspots in the diagnosis and treatment of myocardial injury and myocarditis in children
心肌损伤和心肌炎是儿科临床医生经常应用的两个诊断用语,心肌酶谱和肌钙蛋白也是经常检测的化验项目,但迄今为止仍有部分儿科医生对心肌酶及其同工酶的临床意义缺乏全面的认识,对如何正确判读化验结果存在一些认识误区.当前,心肌损伤和心肌炎被过度诊断、过度治疗的现象并不少见.另外对心肌损伤新的标志物(心肌肌钙蛋白、高敏肌钙蛋白)还缺少深入的了解和认识.本文对上述临床热点问题展开讨论并介绍有关新进展,期望能用正确认知指导今后儿童心肌损伤、心肌炎的诊疗工作.
更多Myocardial injury and myocarditis are the two diagnostic words frequently used by pediatricians,myocardial enzymes and cardiac troponin are also frequently detected in laboratory tests. But up to now,some pediatricians still lack a comprehensive understanding of the clinical significance of cardiac enzymes and their isoenzymes. There are still some misunderstandings about how to interpret the test results correctly. Currently,it is not uncommon for myocardial injury and myocarditis to be over-diagnosed and over-treated. In addition,new biochemical markers of myocardial injury ( cardiac troponin and highly sensitive troponin) are not well understood. This paper discussed the above clinical hot issues and introduced the relat-ed progress. It is expected that correct cognition can guide the diagnosis and treatment of myocardial injury and myocarditis in children in the future.
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