1.Analysis of diagnosis and treatment of 23 infants with atrial tachycardia
Guiming YANG ; Rong JIANG ; Sheng ZHAO ; Liyun ZHENG ; Dahai ZHANG ; Yungong WANG ; Xiaobi HUANG ; Jun GUO
Chinese Journal of Postgraduates of Medicine 2019;42(3):204-207
Objective To study the clinical characteristics, respond of treatment and prognosis in infants with atrial tachycardia (AT). Methods The clinical data of 23 infants with AT from August 2014 to November 2016 were retrospectively analyzed. The respond of treatment and prognosis were observed. Results Of all the 23 infants with AT, incessant AT was in 5 cases, and paroxysmal AT was in 18 cases. There were 13 infants diagnosed with AT combined with cardiac insufficiency, and among them, 5 cases were combined with tachycardia induced cardiomyopathy (TIC). Echocardiography showed that atrial septal defect in 3 cases, patent foramen oval in 6 cases, ventricular septal defect in 1 case, ventricular septal defect combined with patent foramen oval in 2 cases, ventricular septal defect combined with atrial septal defect in 1 case, and ventricular septal defect combined with coarctation of the aorta in 1 case. The curative effect was excellent in 11 cases, effective in 8 cases, and ineffective in 4 cases at discharge. There was no statistical difference in curative effect between patients with normal cardiac function and cardiac insufficiency at discharge (P>0.05). The infants were followed up for 12 months, AT disappeared in 19 cases, 1 case progressed to sick sinus syndrome, and 3 cases were lost in follow-up. Conclusions AT can be insidious in infants, but with a favorable prognosis if treated with cardiotonic drugs and antiarrhythmic drugs during the short and mid-term follow-up. Long-term follow-up should be taken to learn more about the prognosis.
2. Clinical analysis of 52 cases of pediatric hypertrophic cardiomyopathy
Xijing HUANG ; Li ZHANG ; Xiaobi LIANG ; Yan CHEN ; Zhouping WANG ; Xiaofei XIE ; Yanfei WANG ; Wei LI ; Jia YUAN ; Lin HU ; Ping HUANG
Chinese Journal of Applied Clinical Pediatrics 2019;34(16):1234-1236
Objective:
To summarize the clinical characteristics of pediatric hypertrophic cardiomyopathy and analyze its etiology for providing guidance for early identification, diagnosis and prognosis.
Methods:
Fifty-two cases of pediatric hypertrophic cardiomyopathy admitted to Guangzhou Women and Children′s Medical Center from January 2012 to June 2018 were retrospectively analyzed and summarized from the aspects of age, gender, family history, clinical features, auxiliary examination, etiology, drug efficacy and disease outcome.
Results:
(1) There were 52 cases in this group including 36 males and 16 females.The ages of patients ranged from 15 days to 14 years (with mean age of 27.7 months, median 6.5 months). A total of 34 patients (65.4%) were followed up for 1-78 months (mean 30.6 months). Echocardiography showed 52 cases of left ventricular wall thickening (100%), 21 cases of double ventricular hypertrophy (40.4%), 18 cases of left ventricular outflow tract obstruction (34.6%), and 18 cases of hepatic enzyme elevation (34.6%). The etiology of 11 cases was clear (21.2%), including 7 cases of type Ⅱ glycogen accumulation, 3 cases of Noonan syndrome and 1 case of primary carnation deficiency.No routine heart transplantation was performed at the end of follow-up, and 12 patients (35.3%) died, 7 cases of whom died in infancy.
Conclusions
Children with hypertrophic cardiomyopathy have a relatively young age, so it is necessary to search for the etiology actively, carry out disease risk assessment, and conduct personalized management and treatment.
3.Regression analysis of risk factors related to coronary artery lesion in children with Kawasaki disease
Cuiping Qian ; Xiaobi Huang ; Sheng Zhao ; Yong Zhang
Acta Universitatis Medicinalis Anhui 2023;58(3):490-494
Objective :
To investigate risk factors related to coronary artery lesion( CAL) in children with Kawasaki disease.
Methods :
Retrospective analysis was conducted on clinical data of 144 children with Kawasaki disease. The cases were divided into two groups according to whether they had CAL or not.There were 50 children in CAL group and 94 children in non-coronary artery lesion(NCAL) group.The clinical and laboratory indicators in the two groups were analyzed and compared,and the diagnostic efficacy of these indicators for Kawasaki disease combined with CAL was analyzed by drawing the receiver operating characteristic (ROC) curve.
Results :
There was no statistical significant difference in age,gender,duration of fever,use time of immunoglobulin,erythrocyte sedimentation rate,C-reactive protein,serum amyloid A,N-terminal pro brain natriuretic peptide,white blood cell,hemoglobin and platelet between the two groups (P>0. 05) .In CAL group,the serum levels of 25-( OH) D3 and albumin were lower,while the levels of alanine transaminase,interleukin-6 and procalcitonin were higher than those in NCAL group (P<0. 05) .Multivariate logistic regression analysis showed that the levels of serum 25-( OH) D3 ( OR = 0. 984,95% CI:0. 974 ~0. 995) ,albumin ( OR = 0. 857,95% CI:0. 771-0. 951) ,alanine transaminase ( OR = 1. 011,95% CI : 1. 005 -1. 017) and interleukin-6 ( OR = 1. 002,95% CI : 1. 000 -1. 005 ) were significantly related with coronary artery lesion in children with kawasaki disease (P<0. 05) .The levels of 25-( OH) D3 ,albumin,alanine transaminase and interleukin-6 in serum had diagnostic value for Kawasaki disease combined with CAL,and the area under the curve (AUC) were 0. 660,0. 652,0. 711,and 0. 700,respectively.The AUC of combined diagnosis of four indicators was 0. 816 .
Conclution
Decrease of serum 25-( OH) D3 and albumin levels,increase of serum interleukin-6 and alanine transaminase levels in children with Kawasaki disease are risk factors for CAL ,combined detection on these multi-indicators have diagnostic value for Kawasaki disease combined with CAL.