严重急性呼吸综合征对心脏影响的初步分析

目的 分析严重急性呼吸综合征(SARS)对心脏的影响。方法 选择发病1周内收住人院的15例SARS患者，收集其在住院期间的胸部平片、心电图、血常规及生化检查，经皮测动脉血氧饱和度和心率等临床资料。根据胸片分单侧肺部受累4例和双侧肺部受累11例两组进行临床分析比较。结果 (1)单侧肺部病变组患者中，发热持续时间超过1周1例，无低氧血症和低白蛋白血症出现，胸片无心影扩大；而双侧肺部病变组患者中，发热持续时间超过1周7例，其中5例患者出现低氧血症，7例患者出现低白蛋白血症，6例出现一过性心影扩大，其中3例表现为右房室大为主，3例以全心增大为主，同时伴有明显肺动脉段突出2例，其心影变化与肺部病变程度成正比。2例出现肌酸肌酶一过性增高。(2)两组多数患者发病后心率有逐渐增快的趋势，发病3周后的心电图检查显示，心率超过100次／min3例，均为窦性心率，仅有1例T波低平，未发现早搏。结论 SARS对心脏有一定损害，其机制除与肺部病变程度有关外，可能还与心肌的直接损伤有关。

The influence of severe acute respiratory syndrome on heart

Objective To investigate the influence of severe acute respiratory syndrome (SARS) on heart Methods Fifteen SARS patients were admitted and the following clinical data of each patient were recorded: chest X-ray, electrocardiogram, blood routine test and blood biochemistry, percutaneous oxygen saturation and heart rate All the patients were divided into two groups according to the pneumonia being unilateral or bilateral Results (1) In all four patients with unilateral pneumonia, no cardiac enlargement,no hypoxemia, no hypoalbuminemia were found In other eleven patients with bilateral pneumonia 6 patients showed enlargment of the heart (3 patients right side and 3 others total cardiac enlargement) and 2 patients accompanied by prominent of the pulmonary artery segment The cardiac enlargement positively corrlelated with the severity of pneumonia Hypoxemia were found in 5 patients and 7 patients had hypoalbuminemia The plasma creatine kinase were elevated in 2 patients (2) Heart rate of most patients tended to be fast with the severity of illness Electrocardiogram showed tachycardia in most of the patients,only 3 patients after 3 weeks of illness showed that heart rate exceeded 100beats/minute Conclusion SARS has influence on heart and positively correlated with the severity of the pneumonia