过敏性紫癜致心脏损害的探讨

目的 探讨对过敏性紫癜（HSP）导致的心脏损害。方法 对19例过敏性紫癜患者进行心电图及血清标志物等检测，了解过敏性紫癜和心脏损害的相互关系。结果 从皮肤出现紫癜到发现心脏损害时间为3～27d，平均11d。心电图异常距发病的时间为12±3．7d。血清心肌标志物Mb阳性率明显高于cTnI，而与CK-MBmass比较无统计学差异。在无心电图异常的HSP患者cTnI阳性率最低，与Mb、CK-MBmass相比有显著差异。结论 患者年龄多较小，随着变态反应的消退和原发病的好转，心脏的损害也随之消失。异常变态反应范围越广，受累的器官越多，心脏损害机会越大、越严重。对HSP患者进行cTnI、Mb、CK-MBmass联合检测，能较好地反映心脏受损情况。一旦发现心脏损害都应积极治疗，早期心脏损害静脉使用肾上腺糖皮质激素可取得满意疗效。

Study of Cardiac Impairment Caused By Allergic Purpura

Objective To study the cardiac impairment caused by allergic purpura (Henoch-Schon-lein purpura, HSP). Methods 19 HSP patients with the cardiac impairment were entered into the study. Electrocardiogram(ECG) and serum markers including Mb,CK-MB and cTnI were detected to evaluate the heart injure. Results The time from emerging purpura to detecting the cardiac impairment was from 3 to 27 days and the average time was 11 days. The time from the onset to the electrocardiographic abnormality was 123.7 days. The positive rate of Mb was obviously higher than cTnI while there was no statistical difference between Mb and CK-Mbmass. In patients whithout abnormal ECG, the positive rate of cTnI was the lowest compare with Mb and CK-MBmass and there was significant difference. Conclusion The patients were usually young and the cardiac impairment would disappear with the subsidence of allergic reaction and the improvement of primary disease. The cardiac impairment would be worse and its prevelence would be higher as the extent of the allergic reaction was wider and the affected organs were more. The combining detectation of cTnI, Mb and CK-MBmass in patients with HSP could reflet information of the cardiac impairment quite well. Active treatment should be taken once the heart was injured in patients with HSP and intravenous glucocorticoste-roid on the patients with the early cardiac impairment would gain the satisfactary therapeutic effect.