论文部分内容阅读
目的 通过对重症急性呼吸综合征 (SARS)患者心肌酶变化的研究 ,探讨SARS患者的心肌损害及其临床意义。方法 依据广东省传染性非典型肺炎病例临床诊断标准 (草案 ) ,选择SARS患者 37例和健康体检者 35例 ,检测血清肌酸激酶、乳酸脱氢酶、AST、肌钙蛋白Ⅰ、肌酸激酶同工酶、肌红蛋白。结果 SARS组肌酸激酶、乳酸脱氢酶、AST(单位均为U/L)明显高于对照组 (分别为 2 85 4 9± 2 6 6 2 1比 10 6 71± 4 3 38;388 5 6± 198 80比 2 0 0 83± 4 4 86 ;71 0 3± 36 14比 2 9 4 3± 8 89,P值均 <0 0 1) ;死亡者均值较存活者高。SARS组肌钙蛋白Ⅰ、肌酸激酶同工酶、肌红蛋白阳性率高于对照组 ,P <0 0 5。病理显示心肌细胞局部变性。结论 SARS患者易合并心肌损害 ,临床收治该病患者时应予以足够的重视。密切监测心脏功能 ,对减少并发症、降低病死率具有重要意义。
Objective To investigate the changes of myocardial enzymes in patients with severe acute respiratory syndrome (SARS) and explore the clinical significance of myocardial damage in SARS patients. Methods According to the clinical diagnostic criteria (draft) of SARS in Guangdong Province, 37 patients with SARS and 35 healthy subjects were selected for serum creatine kinase, lactate dehydrogenase, AST, troponin Ⅰ, creatine kinase Isoenzyme, myoglobin. Results The levels of creatine kinase, lactate dehydrogenase and AST in the SARS group were all significantly higher than those in the control group (2 854 9 ± 2 6 6 1 1 vs 10 6 71 ± 4 3 38; 388 5 6 ± 198 80 vs 20 0 83 ± 4 4 86; 71 0 3 ± 36 14 vs 294 3 ± 8 89, P <0 01). The mean of deaths was higher than that of survivors. The positive rates of troponin I, creatine kinase and myoglobin in SARS group were higher than those in control group (P <0.05). Pathology showed local degeneration of cardiomyocytes. Conclusions Patients with SARS are likely to have myocardial damage and should be given sufficient attention in the clinical treatment of this disease. Close monitoring of cardiac function is important for reducing complications and reducing mortality.