Journal of Clinical Pediatrics ›› 2026, Vol. 44 ›› Issue (1): 79-83.doi: 10.12372/jcp.2026.24e1172
• Literature Review • Previous Articles Next Articles
Received:2024-11-04
Accepted:2025-03-13
Published:2026-01-15
Online:2026-01-05
CLC Number:
ZHANG Wenting, FENG Juan. Progress in pediatric Takotsubo syndrome[J].Journal of Clinical Pediatrics, 2026, 44(1): 79-83.
Table 1
Differential diagnosis of pediatric Takotsubo cardiomyopathy"
| 项目 | 临床症状 | 心肌酶 | 心衰标志物 | 心电图 | 心脏超声 |
|---|---|---|---|---|---|
| 应激性心肌病 | 晕厥、抽搐、意识丧失多见,病情进展迅速,低心排表现 | CK-MB和hs-cTn升高,但不显著 | BNP和NT-proBNP显著升高,24~72小时达峰值。 | 胸前导联ST段抬高,QT间期延长常见,病理性Q波和ST段压低少见 ,心律失常等 | 左心室功能不全或减低;心腔无明显扩张或轻度扩大;心尖部室壁运动降低,基底部运动增强;心室壁无明显增厚;可有不同程度房室瓣反流,一般不严重;也可累及右心 |
| 扩张型心肌病 | 一般为慢性起病,心力衰竭、心律失常和栓塞是主要特征,常以胸闷气促、咳嗽为首发症状 | 一般不合并CK- MB和hs-cTn的显著升高 | BNP和NT-proBNP可明显升高 | 以ST-T改变最常见,以V5导联最明显;房室肥大以左心房和左心室肥大较常见;心律失常可有多种并存 | 左心/全心功能不全;心腔明显扩大,以左心腔为著;弥漫性心肌活动减弱;心室壁厚度正常或变薄;房室瓣反流常见且明显,也可累及右心 |
| 暴发性心肌炎 | 早期可有嗜睡、腹痛等非特异症状;急性期晕厥、抽搐、意识丧失多见,病情进展迅速,低心排表现 | CK-MB和hs-cTn显著升高 | BNP和NT-proBNP可明显升高 | 多种改变:QRS低电压、ST-T改变;可合并严重心动过速和传导 阻滞 | 左心室功能不全;心腔无明显扩大或轻度扩大;弥漫性心肌活动减弱;疾病早期心室壁增厚;很少累及 右心 |
| 脓毒症性心肌病 | 严重感染的基础临床表现,心功能减退/不全表现 | CK-MB和cTn可升高,差异较大 | BNP和NT-proBNP升高但水平差异较大 | 表现不特异,可有ST-T段抬高或压低,传导阻滞等多种表现 | 左心/全心功能减退/不全;左心室扩张;不伴有局部心室壁收缩或舒张功能障碍 |
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