{"countAll":0,"orderType":null,"readLevel":"0","lyTopicReq":{"id":"1180","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":null,"content":null,"barId":"1180","topicTypeId":null,"topicThemeId":"1026","readLevel":0,"files":null,"clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":null},"lyBarModerators":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":8,"pageNumber":0,"totalPage":0,"totalRow":0},"metaSearch":{"description":"为您提供:小儿心肌炎怎么引起的_诱发小儿心肌炎的病因都有哪些等相关信息，让病友在便捷的求医路上不花一分冤枉钱。","keywords":"小儿心肌炎怎么引起的_诱发小儿心肌炎的病因都有哪些","title":"小儿心肌炎怎么引起的_诱发小儿心肌炎的病因都有哪些","channels":null},"data":{"list":[{"id":"11154","isDel":0,"createAt":1516087169235,"createBy":"8abb11d0af1511e7a3d800163e04584d","createName":"良药苦口","updateAt":0,"updateBy":null,"updateName":null,"userId":"8abb11d0af1511e7a3d800163e04584d","title":"专家告诉您小孩心肌炎的发病原因","content":"

\"专家告诉您小孩心肌炎的发病原因\"

 

据找良医网专家统计发现，小儿患有心肌炎这种疾病几率较高，而且在这种疾病发病之前小孩往往只是会出现感冒的现象，为此一旦孩子发生疾病的时候不要拖拖拉拉的，这样不仅会影响到孩子的生长发育，严重者还会加重心肌炎这种疾病的病情。

 

病毒性心肌炎，是宝宝感冒后的又一大险情。近些年，医学界越来越重视的事情就是由于感冒没有得到及时治疗，使一些宝宝在不经意中患了较为严重的心脏疾病。感冒大多源于病毒侵袭，比如流感病毒、柯萨奇病毒、埃可病毒、腺病毒、疱疹病毒、腮腺炎病毒等。这些病毒，特别是柯萨奇病毒和埃可病毒，对于心肌有特殊的亲和力，在引起呼吸道炎症的同时可向心肌发难，病毒性心肌炎就是这样形成的。

 

为此，找良医网专家在这里建议孩子的父母不要把孩子的感冒不当一回事，而且家长应该了解这种疾病的相关临床表现，观察孩子在临床上具有什么表现，一旦发现具有和心肌炎相关的临床表现一定要及时的治疗，不要延误了孩子的最佳治疗时机。

 

最后，找良医网祝大家身体健康！


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\"小儿感冒：埋下心肌炎的祸根\"

感冒全年都可以发生，尤其是在气温急骤变化、寒冷或盛夏炎热时更容易患感冒。

 

然而，有的孩子功课比较紧张，在感冒时甚至感冒伴有发热时也舍不得休息，结果埋下了病毒性心肌炎的祸根。

 

值得强调的是，小儿感冒时如果有胃肠道表现，如恶心、呕吐、腹痛和腹泻，有时腹泻可以很轻，只是大便比平时稀一些、不成形一些，这种有胃肠道表现的感冒，病毒种类常是柯萨奇病毒等，柯萨奇病毒引起的感冒最容易引起心肌炎的祸根，所以可别轻视小小的感冒哦！

 

小儿患了感冒后1～3周内要重视对病情的观察，尤其对感冒时有胃肠道症状（如伴有发热、全身不适、咳嗽、咽痛、恶心、呕吐、腹痛、腹泻）或感冒的病程超过一周以上才好的小儿更要注意。

 

病毒性心肌炎以大年龄的孩子较多，多数在6～12岁时期。

 

对大年龄孩子在感冒后1～3周，出现无精打采、面色苍白、乏力、多汗、食欲不振、心悸、气短、胸闷、胸痛、心前区不适，甚至心前区疼痛或压迫感，心跳慢或心跳快和心跳不整齐，以上任何表现持续存在，都要警惕是否得了心肌炎，并带孩子到医院检查。

 

也有的小孩感冒后没有上述的表现，而只是感到小腿肌肉疼痛，这是病毒侵犯腿肌的表现。

 

心肌也是肌肉，对小腿肌肉疼痛的小儿进行检查，有部分孩子有早期或无症状性心肌炎。


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\"小孩心肌炎是怎么引起的\"

 

在小孩心肌炎以病毒性心肌炎发病率较高，其“元凶”是病毒，最常见的一种是称为“柯萨奇”的肠道病毒，其他还有一些能引起呼吸道和肠道疾病的病毒，如腺病毒和艾柯病毒等。 病毒可以通过两种方式对心脏产生损害：一种是病毒进入机体后，随血流到达心脏，直接进入心肌细胞，对细胞形成破坏；另一种是病毒进入机体后，诱使机体自身产生一些伤害心肌细胞的物质，使心肌细胞受到损伤。

 

感冒好了，却出现胸闷、心慌、乏力、易出汗等症状？这也许就是病毒性感冒累及心脏导致了心肌炎。据研究，约有5%病毒感染者感染后可累及心脏发生心肌炎。 病毒性感冒或上呼吸道感染容易引发心肌炎，其原因是病毒感染后的直接侵袭心肌，也可能是病毒感染后的自身免疫反应所致。 如果孩子感冒后，出现常常深呼吸、叫累、乏力、胸痛等情况，就可能是病毒性感冒导致了心肌炎，要到医院请医生判断。

 

感冒好了，却出现胸闷、心慌、乏力、易出汗等症状？这也许就是病毒性感冒累及心脏导致了心肌炎。据研究，约有5%病毒感染者感染后可累及心脏发生心肌炎。 病毒性感冒或上呼吸道感染容易引发心肌炎，其原因是病毒感染后的直接侵袭心肌，也可能是病毒感染后的自身免疫反应所致。 如果孩子感冒后，出现常常深呼吸、叫累、乏力、胸痛等情况，就可能是病毒性感冒导致了心肌炎，要到医院请医生判断。

 


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\"小儿感冒或许是心肌炎前兆\"

症状心肌炎分三种类型

　　

暴发型：起病常常没有任何先兆症状和体征，来势凶猛，临床常表现为突然抽风。暴发型还可以表现为突然心力衰竭中血压突然降低而出现心源性休克等。

 

隐匿型：起病时常没有明显的呼吸道和肠道感染的前驱病史，常在劳累后出现身体不适，去医院检查时，才发现心脏扩大、心功能减退。

 

一般型：起病前1-2周常有呼吸道或肠道感染史，如感冒，腹泻等，然后出现胸闷、气短、乏力、面色苍白等症状，去医院检查可能会发现心脏扩大，心音低钝或心律不剂等体征。

 

特别提醒感冒可能是得病前兆

 

找良医网提醒说，每年春季昼夜温差变化大，小儿极易感冒，一般感冒时，服些药，多喝水，休息一下就会好，因而常不被人们重视，可是有些感冒比较特殊，得病后很痛苦，有的小儿还可因此而丧失性命，这种“感冒”其实是病毒性心肌炎的前期症状。


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\"小儿心肌炎病因\"

  (一)发病原因心肌炎常见病因。

 

　　可引起病毒性心肌炎的病毒常见的为腺病毒(特别是血清型2及5)和肠道病毒(柯萨奇病毒A及B组、埃可病毒、脊髓灰质炎病毒)，其中以柯萨奇病毒B组(CVB)最为常见。其他可引起病毒性心肌炎的病毒包括：单纯疱疹病毒、水痘及带状疱疹病毒、巨细胞包涵体病毒、风疹病毒、流行性腮腺炎病毒、C型肝炎病毒、登革热病毒、黄热病病毒、狂犬病病毒、呼吸道肠道病毒等。

 

　　近年来应用聚合酶链反应(PCR)技术检测病毒基因序列，提高了心肌炎的病因诊断。曾报道疑为病毒性心肌炎58例，患儿年龄2天～13岁，用PCR方法检测患者血液中人类小RNA病毒，阳性率为48%，其中4例进行斑点杂交，确定为柯萨奇B3病毒。以往由于病因诊断不明，所谓特发性心肌炎或间质性心肌炎，其中部分病例可能是病毒性心肌炎。

 

　　(二)发病机制

 

　　1.发病机制 心肌炎的发病机制目前尚未完全阐明。加拿大学者Liu及Mason等根据近年的研究成果将心肌炎的发病过程分为3个阶段，即病毒感染阶段、自身免疫阶段及扩张性心肌病阶段。

 

　　近年的研究表明，哺乳动物存在柯萨奇病毒及腺病毒共同受体(CAR)，CAR可易化这些病毒与细胞接触后进入细胞内部，因而是病毒感染的关键步骤。补体弯曲蛋白衰减加速因子(DAF)及整联蛋白αVβ3及αVβ5有协助CAR的作用。病毒感染后免疫反应产生。一旦免疫系统激活，则进入自身免疫阶段。在这一阶段，T细胞因分子的类似性将宿主细胞作为目标攻击，一些细胞因子及交叉反应自身抗体均能加速这一过程。T细胞的激活与病毒肽段有关，相关细胞因子有肿瘤坏死因子α，白细胞介素-1及白细胞介素-6等。在扩张性心肌病阶段，心肌发生重塑。Badorff 及 Knowlton等研究显示柯萨奇病毒蛋白酶与心肌重塑有关。其他相关因子包括基质金属蛋白酶、明胶酶、胶原酶及弹性蛋白酶。这些酶的抑制剂的应用可明显减轻扩张性心肌病的程度。此外，病毒还可直接引起心肌细胞凋亡。

 

　　2.病理变化 心脏显示不同程度的扩大。外观上心肌非常松软。在显微镜下可见心肌纤维之间和血管周围的结缔组织中有单核细胞、淋巴细胞及中性粒细胞的浸润。心肌纤维有不同程度的变性，横纹消失，肌浆凝固和(或)溶解，呈小灶性、斑点状或大片坏死。心肌溶解，胞核和胞浆都可消失，残留细胞膜。心脏病变分布常以左室及室间隔最重，其次为右室，左、右心房最轻。病毒性心肌炎多伴有浆液纤维素性心包炎，渗液量较小。有的并有心内膜炎。在慢性病例，除心肌纤维变性外，可见成纤维细胞增生及瘢痕形成，心内膜弹力纤维增生及心室附壁血栓形成，附壁血栓脱落时可引起脑、肾、肺等梗死。电镜检查可见心肌细胞破碎，肌丝丧失，肌纤蛋白结构破坏，线粒体退行性变和钙化。从死亡病例的心包、心肌或心内膜中可分离出病毒，也可应用PCR方法在心肌、心包或心内膜中找到特异病毒核酸。电镜检查可见病毒颗粒。

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