187例重型病毒性肝炎心电图及心肌酶谱改变的临床分析

目的探讨重型病毒性肝炎的心电图及心肌酶谱改变与心脏损伤的关系。方法选取本院收治的重型病毒性肝炎患者187例作为观察组,其中急性重型肝炎12例,亚急性重型肝炎46例,慢性重型肝炎129例;另选同期体检健康者97例作为对照组,分别进行常规心电图检查,同时检测心肌酶谱,并对以上结果进行对照分析。结果重型病毒性肝炎能引起心电图显著异常,主要为窦性心动过速、窦性心动过缓、ST-T改变、Q-T间期延长、QRS波低电压等。观察组肌酸激酶（CK）明显升高的患者,其心电图异常率明显高于CK正常者,尤其是重肝患者出现窦性心动过速合并ST和（或）T波改变时,CK明显高于正常水平。结论心电图可以作为重型病毒性肝炎心脏损伤严重程度的重要指标,临床应密切关注心电图改变。

Clinical analysis of electrocardiogram changes in 187 patients with severe viral hepatitis

Objective To explore the relationship between electrocardiogram,myocardial enzymes and myocardial injury of severe viral hepatitis.Methods A total of 187 patients with severe viral hepatitis were selected as observation group,including 12 patients with acute severe viral hepatitis,46 with subacute severe viral hepatitis and 129 with chronic severe viral hepatitis.Another 97 healthy subjects were selected as control group.The electrocardiogram and myocardial enzymes were detected,and the results were compared and analyzed.Results The severe viral hepatitis led to abnormal ECG changes such as sinus tachycardia,sinus bradycardia,ST-T change,a longer Q-T period and low voltage of QRS wave.The rate of abnormal ECG of patients with CK increased significantly in the observation group which was higher than that of patients with normal CK.When sinus tachycardia combined with ST and（or） T wave altered,the level of CK was higher than the normal level.Conclusion ECG can be used as an important indicator of the severity of myocardial injury in severe viral hepatitis.Clinical physician should pay close attention to ECG changes.