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。
Objective： To understand the cardiac involvement of Dengue fever patients and to analyze the clinical characteristics of Dengue fever combining cardiac complications. Methods： A total of 395 patients of Dengue fever treated in our hospital were analyzed. Blood levels of CK, CK-MB, CTnT, NT-proBNP were examined, ECG and echocardiography （UCG） were conducted in all patients. Upon Dengue recovery, the levels of CK and CK-MB were re-examined in patients with elevated indexes. Results： Overall, there were 47.3% patients with increased CK, 61.3% with increased CK-MB, 42.5% with increased CTnT and 22.4% with increased NT-proBNP; 37.2% patients with abnormal ECG and 29.9% with abnormal UCG. There were 65.5% patients showing CK and CK-MB reduction more than 4 days upon Dengue recovery. Compared to those without the history of heart disease （HD）, the patients with HD history had the higher abnormal rates of CTnT （17.7 vs 60.8） %, NT-proBNP （4 vs 32.3） % and ECG （25.1 vs 51.7） %, UCG （15.7 vs 41.7） %, all P〈0.01. The abnormal rates in patients with heart failure （HF） were higher than those without HF as in CK-MB （75.8 vs 53.2） %, cTnT （85.5 vs 31.7） % and ECG （87.1 vs 31.7） %, UCG （63.8 vs 17.0） %, all P〈0.01. The abnormal rates in elder patients were higher than non-elder patients as in CTnT （64.4 vs 7.7） %, NT-proBNP （32.2 vs 4.9） % and ECG （53.4 vs 21.8） %, UCG （38.9 vs 14.1） %, all P〈0.01. The patients with elder age and HD history were more likely to have cardiac involvement upon Dengue infection. Conclusion： Blood levels of CK, CK-MB, CTnT, NT-proBNP and ECG, UCG could be used to evaluate the patients with Dengue fever in order to prevent the cardiac complications at the early stage.
出处
《中国循环杂志》
CSCD
北大核心
2015年第12期1195-1199,共5页
Chinese Circulation Journal
关键词
登革热
心肌疾病
诊断
Dengue fever
Cardiamyopathies
Diagnosis
