摘要
目的:分析新型冠状病毒肺炎(COVID-19)患者超声心动图表现及临床特点,探讨COVID-19患者是否存在潜在的心肌损伤。方法:98例在武汉大学人民医院确诊的COVID-19患者,均行超声心动图检查,常规测量各腔室大小、室壁厚度以观察是否存在心脏结构性改变;测量左室射血分数(LVEF)、三尖瓣环收缩期位移(TAPSE)、舒张功能分级以评估心脏功能;收集患者心脏相关的临床资料,主要包括实验室检查、心电图检查结果;依据患者危重程度,将患者分为重症组与非重症组,分析两组患者超声检查结果及临床资料间是否有差异。结果:本研究并未发现有心脏腔室增大、室壁增厚、心功能异常等典型病毒性心肌炎的超声心动图表现;尽管两组患者LVEF值差异具有统计学意义,但重症组患者的LVEF平均值仍在正常范围内;超声心动图阳性征象主要包括少量心包积液和肺动脉高压征象;重症组年龄明显偏大[年龄中位数66.0(IQR:56.0~77.0)岁vs 59.0(IQR:42.0~69.0)岁,P=0.02],同时重症组C-反应蛋白、降钙素原、D-二聚体水平明显升高。结论:新型冠状病毒感染患者的超声心动图缺乏典型表现,但重症患者心肌标志物水平明显增高,提示可能存在潜在心肌损伤。
Objective:To analyze the echocardiographic manifestations and clinical features of 98 patients with COVID-19,and to explore whether there is potential myocardial injury in COVID-19 patients.Methods:Patients diagnosed with COVID-19 in Renmin Hospital of Wuhan University were retrospectively investigated.Echocardiography was performed on all the patients.Diameters of chamber,thickness of ventricular wall were measured routinely to explore whether there were structural changes,while left ventricular ejection fraction(LVEF) and tricuspid annular plane systolic excursion(TAPSE) were assessed for function evaluation.Signs of pericardial effusion and pulmonary hypertension were also focused on in our study.At the same time,clinical data related to the myocardial injury was collected,including Troponin I(cTnI),creatine kinase-MB(CKMB),and N-terminal pro-brain natriuretic peptide(NT-pro BNP).Patients were divided into the severe group and the non-severe group,and the differences of ultrasound results and clinical data between the two groups were analyzed.Results:No typical echocardiographic signs of viral myocarditis were observed in our study,such as ventricular enlargement,thickening of the ventricular wall and cardiac dysfunction.Positive findings in echocardiography observed mainly included signs of pericardial effusion and pulmonary hypertension.By comparing the clinical data of the two groups,the age of the severe group was significantly older(median age 66.0 years [IQR:56.0-77.0] vs 59.0 years [IQR:42.0-69.0],P=0.02),and the levels of CRP,procalcitonin and D-Dimer were significantly increased in the severe group.Conclusion:Although the echocardiography of patients with COVID-19 had no typical manifestations,the level of myocardial markers was significantly increased in severe patients,suggesting the potential myocardial injury.
作者
王浩
邓倾
张瑶
胡伟
程玉婷
周晓阳
闫杰
平海芹
胡波
WANG Hao;DENG Qing;ZHANG Yao;HU Wei;CHENG Yuting;ZHOU Xiaoyang;YAN Jie;PING Haiqin;HU Bo(Dept.of Ultrasound Imaging,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Dept.of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2021年第6期872-877,共6页
Medical Journal of Wuhan University
基金
国家自然科学基金资助项目(编号:81971624)。
关键词
新型冠状病毒
心脏
超声心动图
Coronavirus Disease 2019(COVID-19)
Heart
Echocardiography
