心电图以ST段抬高为特征的老年急性心肌炎临床特点分析

目的分析心电图以ST段抬高为特征的老年急性心肌炎临床特点。方法回顾性分析2010年2月—2016年3月来我院就诊的62例老年急性心肌炎患者。根据心电图表现分为ST段抬高组34例,非ST段抬高组28例,比较2组患者的一般情况、临床表现、实验室检查、超声心动图、冠状动脉造影、治疗资料及不良事件等。结果与非ST段抬高组相比,ST段抬高组急性心肌炎老年患者入院时心率较快,入院时收缩压和舒张压较低,差异均有统计学意义(P <0. 05); ST段抬高组中急性暴发性心肌炎患者21例(61. 76%),非ST段抬高组9例(32. 14%),差异有统计学意义(P <0. 05); ST段抬高组白细胞计数、肌酸激酶(CK)峰值、肌酸激酶同工酶(CKMB)峰值和肌钙蛋白Ⅰ(TnⅠ)峰值较非ST段抬高组高,差异有统计学意义(均P <0. 05); 2组患者住院期间均有发生不良事件,其中ST段抬高组心源性休克(26. 47%)、室颤(14. 71%)、住院期间病死率(20. 59%)均高于非ST段抬高组。结论 ST段抬高组老年急性心肌炎患者起病急、病情重,危险程度较非ST段抬高组老年急性心肌炎患者高,应及时正确判断并积极治疗,合理应用机械辅助治疗,减少不良事件的发生。

Analysis of clinical characteristics of ST segment elevation in elderly patients with acute myocarditis

Objective To analyze the clinical characteristics of ST segment elevation in elderly patients with acute myocarditis. Methods A retrospective analysis was conducted in 62 patients with acute myocarditis from February 2010 to March 2016 in our hospital. According to electrocardiogram, 34 cases were divided into ST-segment elevation group and28 cases in non-ST segment elevation group. The general situation, clinical manifestation, laboratory examination, echocardiography, coronary angiography, treatment data and adverse events were compared between the two groups. Results Compared with non-ST segment elevation group, the heart rate of ST segment elevation group was higher, and the systolic blood pressure and the diastolic blood pressure of ST segment elevation group were lower (P < 0.05). There were 21 patients with acute fulminant myocarditis in the ST segment elevation group and 9 in the non-ST segment elevation group, the difference was statistically significant (P < 0.05). ST segment elevation group of white blood cell count, peak creatine kinase (CK), creatine kinase isoenzyme MB (CKMB) peak and troponin I (Tn Ⅰ) peak is higher than non-ST segment elevation group, the difference was statistically significant (P < 0.05). Adverse reactions occurred during hospitalization in both groups, among which cardiogenic shock (26.47%), ventricular fibrillation (14.71%) and inpatient mortality (20.59%) in the ST elevation group were higher than those in the non-ST elevation group. Conclusion ST-segment elevation in elderly patients with acute myocarditis acute onset and severe has higher risk than non-ST segment elevation elderly patients with acute myocarditis, should be timely and correctly treatment, the rational application of mechanical adjuvant therapy, can reduce the incidence of adverse reactions.