急性重型病毒性心肌炎29例临床剖析.docVIP

急性重型病毒性心肌炎29例临床剖析 　　[摘要] 目的：总结急性重症病毒性心肌炎的不同临床表现及诊治经验。方法：对2005年1月～2010年1月本院诊治的29例急性重症病毒性心肌炎患者的临床资料进行回顾性分析。结果：所有患者在起病前数周内均有发热、咳嗽、流涕等上呼吸道感染症状或伴有腹泻、呕吐、腹痛等消化道症状，且不能用消化道及神经系统的原发疾病来解释。根据是否伴随有心源性休克分为A、B组，两组经比较一般资料、临床表现、心电图和辅助检查结果差异无统计学意义（P0.05）；A组2例死于心源性休克，死者病程短为（1.5±0.3） d，1例偶发室性期前收缩；B组心悸、头昏乏力、胸痛等症状基本消失，心肌酶、心电图及超声心动图恢复正常者8例。两组的疗效比较发现A、B两组缓解率分别为71.43%、83.36%。结论：对急性重症病毒性心肌炎及时诊断和采取有效的治疗措施，可降低死亡率和改善预后。 　　[关键词] 心肌炎；病毒性；治疗；分析 　　[中图分类号] R542.2+1 [文献标识码]A[文章编号]1674-4721（2011）04（a）-028-02 　　 　　Clinical research on 29 cases of acute fulminant viral myocarditis 　　ZHONG Lilan 　　People′s Hospital of Ningxiang County, Hunan Province, Ningxiang 410660, China 　　[Abstract] Objective: To summarize the clinical features of patients with acute viral myocarditis. Methods: The clinical data of 29 patients with severe acute diagnosis was retrospectively analyzed from January 2005 to January 2010. Results: The symptoms of fever, cough, runny nose upper respiratory infection symptoms were found for the patients with severe acute diagnosis.group A and Bby comparison, the clinical manifestation, electrocardiogram and auxiliary examination results in group A and B showed no significant difference (P0.05). 2 cases died of heart in group A, with a short shock duration: (1.5±0.3)days, group B palpitations, the symptoms of dizziness, weakness, and chest pain symptoms disappeared basically. And the myocardial enzymes, electrocardiogram, echocardiographic restored normal in 8 cases. Two groups was found the curative effect of group A and B was respectively for 71.43%, 83.36%. Conclusion: For patients with acute viral myocarditis, timely diagnosis and taking effective measures are proved to be important, they can reduces mortality and improve the prognosis. 　　[Key words] Myocarditis; Viral; Treatment; Analysis 　　 　　急性重症病毒性心肌炎（acute severe viral myocarditis，ASVM），是指各种病毒感染后所致心肌严重炎性损害。临床表现轻重不一，突出表现为严重心律失常、心源性休克，甚至猝死，急性期病死率可达10%以上[1]。该病病情凶险，如不及时诊断及治疗，预后极差，因此有必要加深对本病的认识，以改善预后，降低死亡率。现对本院2005年1月～2010年1