摘要
目的:探讨疑诊暴发性心肌炎(FM)伴ST段抬高患者行急诊冠脉造影的安全性和对患者预后的影响。方法:81例诊断为FM患者根据入院后是否行急诊冠脉造影分为造影组(31例)和对照组(50例),比较2组入院心电图特征、院内死亡率、住院期间心肌损伤标志物cTnI峰值、心衰标志物NT-BNP峰值、出院前肝、肾功能、住院天数等。结果:造影组入院心电图ST-T呈急性心肌梗死样改变29例(93.5%)明显多于对照组26例(52%),差异有统计学意义(P<0.0001),造影组院内死亡率、住院期间心肌损伤标志物cTnI峰值、心衰标志物NT-BNP峰值、出院前肝、肾功能、住院天数与对照组比较无统计学差异(P>0.05)。结论:急诊冠脉造影不增加病死率,不加重病情,提示对疑诊FM伴ST抬高的患者行急诊造影安全可靠。患者能从早期明确诊断中获益,可能有利于患者的预后。
Objectives：To evaluate the application of emergency coronary angiography in patients with fulminant myocarditis（FM） and ST-segment elevation. Methods：A total of 81 patients diagnosed with（FM） were evaluated retrospectively. According to whether emergency coronary angiography was performed after admission,all the patients were divided into angiography group（31 cases） and control group（50 cases）. The ECG characteristics at admission,mortality,cardiac injury markers peak（cTnI）,heart failure markers peak（NT-BNP）,liver and kidney functions before discharge,and duration of hospitalization were compared between two groups. Results：ECG changes like acute myocardial infarction at admission in angiography group（93. 5%） were more than those in control group（52. 0%）（P 〈0. 0001）. Mortality,cTnI peak value,NT-BNP peak value during hospitalization,liver and kidney function before discharge and hospital stays were not significantly different between the two groups（P〈0.05）. Conclusions：Emergency coronary angiography doesn＇t increase mortality of patients with FM and doesn＇t aggravate the disease situations. Our data suggest that the emergency angiography is safe and reliable for patients with suspected FM and ST-segment elevation. Patients can benefit from early definite diagnosis. It may imply that emergency coronary angiography is helpful for the prognosis.
出处
《内科急危重症杂志》
2017年第6期462-464,共3页
Journal of Critical Care In Internal Medicine
关键词
暴发性心肌炎
急性心肌梗死
急诊冠脉造影
Fulminant myocarditis
Acute myocardial infarction
Emergency coronary angiography
