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目的探讨急性重症病毒性心肌炎的发病特点、治疗和预后。方法回顾分析2002年7月—2012年4月本院收治的40例急性重症病毒性心肌炎的临床资料。结果 40例急性重症病毒性心肌炎病人中有明确病毒感染史者26例;临床表现多样化,以心律失常或心力衰竭引起的相关症状为主诉的相对多见;心电图以恶性室性心律失常及Ⅲ度房室传导阻滞多见,超声心动图多数提示室壁运动减弱,左心收缩或舒张功能异常;血清肌钙蛋白-I、磷酸肌酸激酶CK-MB均明显升高。30例治愈出院,2例遗留心律失常,8例死亡。结论急性重症病毒性心肌炎起病急,进展快,急性期病死率较高,但如果临床足够重视,早期识别,并进行积极有效的综合治疗,可使大部分患者完全恢复。
Objective To investigate the incidence, treatment and prognosis of acute severe viral myocarditis. Methods The clinical data of 40 cases of acute severe viral myocarditis admitted to our hospital from July 2002 to April 2012 were retrospectively analyzed. Results Of the 40 patients with acute severe viral myocarditis, there were 26 patients with a clear history of virus infection. The clinical manifestation was diversified. The relative symptoms were mainly relative to arrhythmia or heart failure. The electrocardiogram showed malignant ventricular arrhythmias and Ⅲ Degree of atrioventricular block more common, most of the echocardiography prompted wall motion decreased, left ventricular systolic or diastolic dysfunction; serum troponin-I, creatine phosphokinase CK-MB were significantly higher. 30 patients were cured and discharged, 2 left behind arrhythmia and 8 died. Conclusions Acute severe viral myocarditis is acute onset, rapid progression and high mortality in acute phase. However, if clinically adequate attention is given to early recognition and active and effective comprehensive treatment, most patients can be fully recovered.