慢性乙型肝炎病毒感染者心肌损伤的临床研究-内科学(传染病学)专业毕业论文.docxVIP

新疆医科大学硕士学位论文 新疆医科大学硕士学位论文 PAGE PAGE 1 慢性乙型肝炎病毒感染者心肌损伤的临床研究 研究生：李琴 导师：鲁晓擘 副教授 摘 要 目的：探讨慢性乙型肝炎病毒感染者与心肌损伤的相关性及临床意义。方法： 对新疆 2 个中心 2010 年 1 月-2011 年 2 月收治的 93 例各种慢性乙型肝炎病毒感染 者的临床资料进行回顾性分析。结果：在慢性乙型肝炎、慢性重型乙型肝炎、乙肝 肝硬化代偿期、乙肝肝硬化失代偿期四组中：1.患者心肌酶均有升高，且慢性重型 肝炎及乙肝肝硬化失代偿期组升高率较其他两组高，但差异无统计学意义(P0.05)。 2.在 93 例患者中有 7 例患者的心电图表现异常，占 7.53%，分别为窦性心动过缓 2 例，前间壁心肌病待排 1 例，前间壁心肌缺血 1 例，心肌损害 1 例，左前分支传导 阻滞 1 例，不全性左束支传导阻滞 1 例，前 6 例来自慢性乙型肝炎组，后 1 例来自 乙肝肝硬化代偿期组。3.在 93 例患者中有 52 例出现了心脏彩色多普勒超声的异常 表现，占 55.91%。在不同组患者中各种异常表现的发生率不同，且多数患者合并有 多种异常改变。在慢性乙型肝炎组中二尖瓣及三尖瓣于收缩期检出反流的发生率明 显较其余三组升高，与慢性重型乙型肝炎组之间有统计学意义(P0.05)，与乙肝肝 硬化组无统计学意义(P0.05)。结论：慢性 HBV 感染者中可出现心肌损伤，可表现 为心肌酶谱、心电图、心脏彩色多普勒超声的异常改变等，可能会导致 HBV 相关 心肌病。慢性 HBV 感染患者若合并心肌损伤，可适当放宽抗病毒指征，同时应积 极保护心肌治疗，延缓疾病进展。 关键词：乙型肝炎病毒；心肌损伤；心电图；心肌酶；心脏彩色多普勒超声 Clinical Research on myocardial injury of Chronic hepatitis B virus infection patients Postgraduate:Li Qin SuPervisor: Associate Prof.Lu Xiaobo Abstract Objective:To study the relation and clinical significance between chronic hepatitis B virus infection and myocardial injury.Methods:To retrospective analyze the clinical date of 93 chronic hepatitis B virus infection patients from January 2010 to February 2011 in Xinjiang two centers.Results:Between the four groups of chronic hepatitis B, chronic severe hepatitis B, the compensatory stage of hepatitis B liver cirrhosis, the decompensatory stage of hepatitis B liver cirrhosis:1. The patients had elevated enzymes, the Abnormally high rate of chronic hepatitis B severe hepatitis group and hepatitis B cirrhosis group is higher than other two groups, but the difference was not statistically significant(P0.05).2. In 93 patients, the electrocardiograms of 7 patients were abnormally, accounting for 7.53%.They are 2 cases of sinus bradycardia,1 case of anteroseptal myocardial disease to be ranked, 1 case of anteroseptal myocardial ischemia, 1 case of left branch block and 1 case of incomplete left bundle branch block. Before 6 cases were from chronic hepatitis B group, the last one cas