重症肾综合征出血热患者心脏伤害的多普勒超声心动图的....docVIP

重症肾综合征出血热患者心脏损害的多普勒超声心动图的...重症肾综合征出血热患者心脏损害的多普勒超声心动图的研究2010-04-23 刘振忠　高冬梅　昃道芝　郭文海　肖爱华 　　【摘要】　目的　研究重症肾综合征出血热(HFRS)患者的心脏损害。方法　应用多普勒超声(UCG)随访观测50例急性期、恢复期HFRS患者及30例正常对照组的心脏解剖结构及心脏功能。结果　急性期患者室壁及心包较正常对照组轻度增厚、动度减弱，不同程度的回声改变。18例有心包积液，38例瓣膜返流，心脏舒缩功能减退。结论　重症HFRS患者心脏损害是心肌、心内膜及心包广泛受累的全心炎症，与预后密切相关。 　　【关键词】　肾综合征出血热　　超声心动图　　心功能　　血流动力学 Study on the injury of heart in the patients with severe hemorrhagic fever with renal syndrome by ultrasonography LIU Zhenzhong,GAO Dongmei,ZHE Daozhi,et al. The Peoples Hospital of Liaocheng,Liaocheng 252000 　　【Abstract】　Objective　To study the injury of heart in the patients with severe hemorrhagic fever with renal syndrome (HFRS).Methods　Fifty patients with HFRS and 30 normal cases as control were examined by Doppler Ultrasonic Cardiography (UCG) at acute as well as recovery phase.The anatomical structure of heart,cardiae function and hemodynamics were measured.Results　The ventricular wall and pericardium of the patients were found to be thickened and its motions were decreased.Echos in the ventri-cular wall and pericardium were enhanced in comparison with that of the normal group.There found to be pericardial effusion in 18 patients and valve regurgitation in 38 patients.The systolic and diastolic function of the left and right ventricular were significantly decreased than that of the normal group (P0.05).Conclusion　The results indicate that the injury of heart caused by severe HFPS is a pancarditis involved in cardiac muscle,endocardium and pericardium.The extent of the injury of heart is correlated with the prognosis of HFRS. 　　【Key words】　Hemorrhagic fever with renal syndrome　　Ultrasound cardiogram　　Cardiac function　　Hemodynamics 　　肾综合征出血热(HFRS)是以肾脏损害为主的全身性多脏器损害的急性传染病，常伴心脏损害。临床上部分HFRS患者的死亡与心律失常，心力衰竭有直接关系，而其死亡的主要原因虽然是严重的肾功能衰竭，但严重肾功能衰竭的患者，常伴有较严重的低血压休克和高血容量综合征，因此均有不同程度的心功能不全和血液动力学异常。采用多普勒超声心动图(UCG)检测心脏解剖结构和心脏功能，可定性、定量了解HFRS患者心脏损害情况。自1995年3月至1997年3月应用UCG动态检测50例重症HFRS患者，现报告如下。 材料与方法 　　一、对象 　　根据卫生部1987年EHF防治方案(试行)的标准确诊，且ELISA法检测EHF特异性抗体IgM阳性的50例重症HF