登革热合并心脏受累的临床特征分析与评估

发布时间：2018-06-14 16:53

本文选题：登革热 + 心肌疾病　；参考：《中国循环杂志》2015年12期

【摘要】：目的:了解登革热患者的心脏受累情况,分析登革热合并心脏受累的临床特征。方法:对我院收治的395例登革热患者进行分析。分别对患者的肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、血肌酐,N末端B型利钠肽原(NT-pro BNP)、肌钙蛋白T(c Tn T)以及心电图(ECG)、超声心动图(UCG)进行分析;待登革热好转,对93例心肌酶升高的患者复查心肌酶。结果:47.3%的患者出现CK升高,61.3%的患者出现CK-MB升高,42.5%的患者出现c Tn T升高,22.4%的患者出现NT-pro BNP升高;ECG异常者占37.2%,UCG异常者占29.9%;65.5%患者心肌酶超过4天才开始明显降低或降至正常;既往没有心脏病史的患者中c Tn T、NT-pro BNP、ECG和UCG异常的发生率均明显少于既往有心脏病史患者(17.7%vs 60.8%,4%vs 32.3%,25.1%vs 51.7%,15.7%vs 41.7%,P均0.01);心力衰竭(HF)的患者中CK-MB、c Tn T、ECG和UCG异常的发生率均明显高于无HF的患者(75.8%vs 53.2%,85.5%vs 31.7%,87.1%vs 31.7%,63.8%vs 17.0%,P均0.01);≥65岁老年患者的c Tn T、NT-pro BNP、ECG和UCG异常的发生率均明显高于65岁患者(64.4%vs 7.7%,32.2%vs 4.9%,53.4%vs 21.8%,38.9%vs 14.1%,P均0.01)。结论:≥65岁老年患者及有心脏病史的患者一旦感染登革热病毒,容易出现心脏受累。可根据CK、CK-MB、c Tn T、NT-pro BNP、ECG以及UCG对登革热患者进行评估,以及早预防各种心脏并发症。
[Abstract]:Objective: to investigate the cardiac involvement in patients with dengue fever and to analyze the clinical features of heart involvement in patients with dengue fever. Methods: 395 cases of dengue fever in our hospital were analyzed. The serum creatine kinase (CK), creatine kinase isoenzyme (CK-MBN), serum creatinine N-terminal B-type natriuretic peptide (NT-pro BNPN), troponin TnTn, and electrocardiogram (ECG), echocardiography (UCGG) were analyzed respectively. Myocardial enzymes were examined in 93 patients with elevated myocardial enzymes. Results in 47.3% of the patients, 61.3% of the patients had elevated CK-MB. 42.5% of the patients had elevated c TnT and 22.4% had increased NT-pro BNP. 37.2% of the patients had abnormal NT-pro BNP and 29.99% had abnormal UCG, 29.9% had abnormal UCG, and 29.9% of the patients had decreased or decreased to normal after more than 4 days. The incidence of abnormal ECG and UCG in patients with no history of heart disease was significantly lower than that in patients with previous history of heart disease. The incidence of abnormal CK-MBc Tn TNPECG and UCG in patients with heart failure was significantly higher than that in patients with history of heart disease (17.7 vs 60.828 vs 32.31 vs 51.7% vs 41.7%), and the incidence of abnormal CK-MBc Tn TnTG and UCG in patients with heart failure and HFV was significantly higher than that in patients with heart failure. The incidence of abnormal c TNT-pro BNPECG and UCG in the elderly patients aged 65 years or older was significantly higher than that in 65 years old patients (64.4 vs 7.732.94.93.4vs 21.88.93.4vs 21.88.93.4vs 38.98.98.93.45 vs 21.88.93.4Vs.88.93.4vs 21.88.93.4Vt = 38.98.98.93.4vs 21.88.93.4vs 21.88.93.4Vt = 21.88.93.4V8.98.91.The incidence of abnormal cTnTNT-pro BNPECG and UCG was significantly higher than that of the 65-year-old patients with abnormal BNPECG and UCG. Conclusion: the patients aged 65 years or older and patients with history of heart disease are prone to heart involvement once they are infected with dengue virus. The patients with dengue fever can be evaluated according to CKCK-MBC / TnTNT-pro BNPECG and UCG, and various cardiac complications can be prevented early.
【作者单位】：广州市红十字会医院暨南大学医学院附属广州市红十字会医院心血管医学部;
【分类号】：R512.8;R542.2

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