儿童暴发性心肌炎的早期识别与分层管理进展

Early Identification and Stratified Management Progress of Fulminant Myocarditis in Children

摘要: 儿童暴发性心肌炎是儿科最为凶险的危重症之一，起病急骤、进展迅速，早期临床表现缺乏特异性，误诊率高。近年来，随着对疾病认识的深化及诊疗技术的进步，儿童暴发性心肌炎的早期识别与分层管理取得重要进展。本文从流行病学特征、病理生理机制、早期识别策略、分层管理工具以及分层治疗方案等方面进行系统综述，重点阐述临床预测模型、生物标志物、心电图及超声心动图在风险分层中的应用价值，以及基于机械循环支持的分层管理策略，旨在为临床实践提供参考。

Abstract: Fulminant myocarditis in children is one of the most critical and life-threatening emergencies in pediatrics. It is characterized by acute onset and rapid progression, with nonspecific early clinical manifestations leading to a high misdiagnosis rate. In recent years, with the deepening understanding of the disease and advances in diagnostic and therapeutic techniques, significant progress has been made in the early identification and stratified management of pediatric fulminant myocarditis. This article systematically reviews the epidemiological characteristics, pathophysiological mechanisms, early identification strategies, risk stratification tools, and stratified treatment approaches, with a focus on the application value of clinical prediction models, biomarkers, electrocardiography, and echocardiography in risk stratification, as well as stratified management strategies based on mechanical circulatory support, aiming to provide a reference for clinical practice.