严重急性呼吸综合征患者心血管系统表现初步临床观察

目的:本文回顾分析了35例确诊严重急性呼吸综合征(SARS)患者在心血管系统方面的临床表现.方法:35例确诊为SARS的患者,其中男性19例,女性16例,平均年龄37.7岁(15～82岁),临床观察项目包括体温、血氧饱和度、心率、血清酶,以及X线影像和超声心动图检查.结果:35例患者中,有10例(28.6%)患者X线胸片显示心脏增大,以右心增大或全心增大为主,其中3例呈现肺动脉段突出,10例中6例为重症患者.X线胸片显示急性期(发病1～2周)心脏影像开始增大,恢复期(发病3～4周),大多数患者(9例)心脏影像恢复正常.10例患者心脏在急性期时平均心胸比率为0.59±0.03,恢复期平均心胸比率为0.51±0.02,二者有显著差异(P＜0.05).所有患者心率加快并长时间呈偏高水平,在体温正常后,平均心率仍在95次/分以上.有5例患者在发热期间发生过心肌酶(肌酸激酶,CK)增高,3～5天后,心肌酶恢复正常.所有患者在恢复期期间行超声心动图检查,仍有1例显示左、右心室增大,其余患者心脏大小均已恢复正常.结论:本组临床观察显示,SARS是以肺部为突出表现的呼吸道传染病,亦可累及心脏使一部分患者心脏增大.随着SARS病情好转大多数增大的心脏可恢复正常,其机制需进一步研究证实.

Clinical Oberservation of Characteristics of Cardiovascular System in Patients With Severe Acute Respiratory Syndrome(SARS)

Objective: To oberserve clinical characteristics of cardiovascular system in patients with severe acute respiratory syndrome(SARS) Methods: Thirty-five patients with SARS,(19 male and 16 female,mean age of 37.7 years) were enrolled in our study.All patients were examined by chest radiography and echocardiography. Results: Ten patients developed heart enlargement (28.6%) during the acute period of SARS and the enlarged heart returned to normal in most patients(9/10) 3-4 weeks later. CK enzyme was increased during the acute period in 5 patients. Conclusions: Although respiratory system is mainly target of SARS, cardiovascular system may be also involved. The heart enlargement was found in some patients (28.6%) and the enlarged heart returned to normal 3-4 weeks later in most patients.