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本文报告了大理地区57例小儿克山病死亡病例,其中亚急型克山病46例,慢型克山病11例。由于小儿表述能力差而且克山病的症状和体征易被呼吸道或消化道感染等夹杂症所掩盖,从而延误了诊断和治疗。作者认为早期诊断和治疗亚急型克山病防止转为慢型是降低克山病病死率的重要措施。25例有明显的营养不良,25例有偏食习惯,18例为人工喂养儿,可见调节膳食防止偏食、改善小儿营养状况是预防克山病的重要措施。血清磷酸肌酸激酶(CPK)活性升高与病理上的心肌新旧病变并存是亚急型克山病早期病例的重要特点之一。
This article reports 57 cases of pediatric Keshan disease deaths in Dali, including 46 cases of subacute Keshan disease and 11 cases of chronic Keshan disease. Due to poor presentation in children and Keshan disease symptoms and signs easily masked by respiratory or gastrointestinal infections and other complications, thus delayed diagnosis and treatment. The authors believe that the early diagnosis and treatment of subacute Kill disease to prevent slow to change is an important measure to reduce the mortality of Keshan disease. 25 cases have obvious malnutrition, 25 cases have partial eclipse habits, 18 cases of artificial feeding children, showing that regulating diet to prevent partial eclipse, improve children’s nutritional status is an important measure to prevent Keshan disease. Increased serum creatine phosphokinase (CPK) activity and pathological myocardial old and new lesions coexist in subacute Keshan disease is one of the important features of early cases.