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病毒性心肌炎合并心律失常与非心律失常的心脏超声及血清学指标对比分析
陈秀明,张力,武立斌,陈小霞
0
(锦州市中心医院功能科,辽宁 锦州 121000;营口市鲅鱼圈开发区中心医院超声科,辽宁 营口 115007;营口市鲅鱼圈开发区中心医院检验科,辽宁 营口 115007)
摘要:
目的 探讨病毒性心肌炎合并心律失常患者与非心律失常患者的心脏超声指标、血清学指标及预后。方法 选取2011年4月~2016年2月于我院就诊的病毒性心肌炎患者93例,按照是否存在心律失常将其分为心律失常组(n=32)和非心律失常组(n=61)。对比两组患者心脏超声指标、血清学指标、临床症状发生率、主动脉内球囊反搏和临时起搏器使用率以及预后情况。结果 心律失常组患者的左心室射血分数、收缩末期容量、舒张末期容量、左室质量、收缩期左心室内径、收缩期室间隔厚度、舒张期室间隔厚度、主动脉内径、左室舒张末期内径、右心房内径、左心室内径、左心房内径、每搏体积和心输出量与非心律失常组患者对比,差异均有统计学意义(P<0.05)。心律失常组患者肌酸激酶同工酶和C反应蛋白等血清学指标与非心律失常组患者对比,差异亦有统计学意义(P<0.05)。心律失常组患者胸闷、晕厥、胸痛、全身症状、呼吸道症状及消化道症状等临床表现均明显高于非心律失常组患者,主动脉内球囊反搏使用率及临时起搏器使用率等均明显高于非心律失常组患者,差异有统计学意义(P<0.05)。心律失常组患者死亡率(18.75%)明显高于非心律失常组患者(1.64%),且差异有统计学意义(P<0.05)。结论〓病毒性心肌炎合并心律失常患者有较高的病死率,较非心律失常患者有更差的心脏超声指标,更严重的临床表现和更差的预后,需及时明确诊断,从而进行有效的治疗。
关键词:  病毒性心肌炎  心律失常  心脏超声
DOI:
基金项目:国家自然科学基金青年科学基金(8130298)
Contrastive analysis of cardiac ultrasound index, serological index and prognosis of viral myocarditis with arrhythmia and noncardiac arrhythmia
CHEN Xiuming,ZHANG Li,WU Libin,CHEN Xiaoxia
(Functional Section, Jinzhou Central Hospital,Jinzhou 121000, Liaoning, China;Department of Ultrasound, Central Hospital of Bayuquan Development Zone, Yingkou 115007, Liaoning, China;;Department of Clinical Laboratory, Central Hospital of Bayuquan Development Zone, Yingkou 115007, Liaoning, China)
Abstract:
Objective To compare the cardiac ultrasound, serum markers and prognosis of patients with viral myocarditis with arrhythmia in patients with noncardiac arrhythmia.Methods 93 patients with viral myocarditis treated in our hospital from April 2011 to February 2016 were divided into noncardiac arrhythmia group (N = 32) and arrhythmias group (n = 61). The cardiac ultrasound and serum markers, the incidence of clinical symptoms, intraaortic balloon pacing and temporary pacemaker use, and the prognosis were observed. Results Left ventricular ejection fraction, end systolic volume, enddiastolic volume, left ventricular mass, systolic left ventricular diameter, systolic ventricular septal thickness, diastolic ventricular septal thickness, aortic diameter and left ventricular enddiastolic of noncardiac arrhythmia group were different from that of arrhythmias group (P<0.05). There were significant differences in serum levels of creatine kinase isoenzyme and Creactive protein between arrhythmia group and noncardiac arrhythmia group (P<0.05). The clinical manifestations including chest tightness, syncope, chest pain, systemic symptoms, respiratory symptoms and gastrointestinal symptoms of arrhythmia group were significantly higher than that of noncardiac arrhythmia group (P<0.05). The Balloon counterpulsation rate and temporary pacemaker use rate of arrhythmia group were significantly higher than noncardiac arrhythmia group (P<0.05). The mortality rate of arrhythmia group (18.75%) was higher than those in noncardiac arrhythmia group (1.64%)(P<0.05).Conclusion Viral myocarditis with arrhythmia patients have a higher mortality than that without arrhythmia.
Key words:  Viral myocarditis  Arrhythmia  Cardiac ultrasound

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