摘要
目的 分析儿童呼吸道感染后出现良性急性肌炎的疾病特点及急诊治疗。方法 回顾性分析2021年5月1日至2022年6月1日因肌痛/跛行、拒走就诊于急诊科的儿童病例40例,收集患儿的一般资料和临床表现,血常规、心肌酶、呼吸道病原抗原检测,治疗及预后。以发病中热峰38.5℃分界,≥38.5℃为中高热组,<38.5℃为中低热组。结果 男29例,女11例;年龄3~12岁,3~6岁18例,6~12岁22例,中位年龄6(5,7)岁,学龄前及学龄儿童多见。发病时间正值冬季,所有病例均为首次发病,且发生于呼吸道感染后。中高热组与中低热组下肢痛持续时间分别为3(3,4.5)d, 3(3,4)d,平均3.63 d,最短1 d,最长6 d,体温变化时间及疼痛程度差异有统计学意义(P<0.05),与疼痛持续时间比较,差异无统计学意义(P>0.05)。中高热组患儿以心肌酶升高为主,中低热组升高不明显,二者差异无统计学意义(P>0.05),心肌酶升高程度与下肢痛持续时间差异有统计学意义(P<0.05)。乙型流感病毒抗原阳性16例,肺炎支原体抗原阳性6例(乙流与支原体同时阳性1例),阴性18例,乙流多见,肺炎支原体次之,不同病原患儿的心肌酶升高程度差异无统计学意义(P>0.05)。采取对症治疗为主,急诊留观及门诊治疗病程3~5 d,与住院时间差异有统计学意义(P<0.05),本病预后好,随访3个月无复发。结论 儿童在呼吸道感染后,特别是乙流感染后突然出现下肢痛及心肌酶异常,需警惕儿童良性急性肌炎,该病具有自限性及预后良好的特点。
Objective To analyze the disease characteristics and emergency treatment of pediatric benign acute myositis associated with respiratory tract infections.Methods Forty pediatric cases with myalgia/claudication,and refusal to walk in the Emergency Department from May 1 in 2021 to June 1 in 2022 were retrospectively recruited.General information,clinical manifestations,blood routine,myocardial enzyme,respiratory pathogen antigen testing,treatment,and prognosis were collected for analyses.According to the peak temperature of 38.5℃during the onset of the disease,children with≥38.5℃were included in the moderate-to-high fever group,otherwise,they were included in the low-to-moderate fever group.Results There were 29 boys and 11 girls included in the present study,with more boys affected than girls.The age ranged from 3 to 12 years old,including 18 cases between 3-6 years old,and 22 cases between 6-12 years old.The median age was 6(5,7)years,and it was more common in preschool and school-age children.The disease occurred during winter,and all cases not only were first-time onset but also occurred after respiratory tract infection.The duration time of pain in the moderate-to-high fever group and the low-to-moderate fever group was 3(3,4.5),and 3(3,4)days,respectively,with an average time of 3.63(1-6)days.There was a significant difference in the time of temperature change and the degree of pain(P<0.05),but no significant difference in the duration of pain between groups(P>0.05).The myocardial enzymes were mainly elevated in children with moderate-to-high fever,while the elevation was not significant in the low-to-moderate fever group,and the difference between the two groups was not statistically significant(P>0.05).There was a significant difference in the degree of elevation of myocardial enzymes and the duration time of pain(P<0.05).There were 16 cases positive for influenza B virus antigen,6 cases positive for Mycoplasma pneumoniae antigen(1 case positive for both influenza B and Mycoplasma),and 18 cases negative.Influenza B was more common followed than Mycoplasma pneumoniae.There was no significant difference in the degree of myocardial enzyme elevation among children with different pathogens(P>0.05).Symptomatic therapy was preferred,with the disease course of 3-5 days in emergency observation and outpatient treatment,showing a significant difference compared to the length of stay.The prognosis was good,without a recurrence after a follow-up of 3 months.Conclusion Children who suddenly experience lower limb pain and abnormal myocardial enzymes after respiratory tract infections,especially after influenza B infection,should be vigilant against benign acute myositis.This disease has self-limiting characteristics and a good prognosis.
作者
袁洁
张中馥
安淑华
魏江玲
葛胜华
YUAN Jie;ZHANG Zhongfu;AN Shuhua(Department of Respiratory Medicine,Hebei Children's Hospital,Hebei,Shijiazhuang 050031,China;不详)
出处
《河北医药》
CAS
2024年第23期3584-3587,3592,共5页
Hebei Medical Journal
关键词
儿童
良性肌炎
乙型流感
磷酸激酶
急诊
children
benign myositis
influenza B
phosphate kinase
emergency department
