人巨细胞病毒性心肌炎与柯萨奇病毒性心肌炎的对比研究

【目的】探讨人巨细胞病毒性心肌炎的临床特点。【方法】对 2 9例人巨细胞病毒性心肌炎与 5 2例柯萨奇病毒性心肌炎在发病年龄、心电图、心肌酶谱、心功能等方面临床对比。【结果】人巨细胞病毒性心肌炎以小婴儿居多 ,经统计学处理 ,差异有显著性 ,学龄前期发病例数接近。人巨细胞病毒性心肌炎患儿血清心肌酶CK MB、CTnT明显高于柯萨奇病毒性心肌炎 ,差异有显著性 (P <0 .0 1 )。心电图变化人巨细胞病毒性心肌炎以传导阻滞为主 ,与柯萨奇病毒性心肌炎比较差异有显著性 (P <0 .0 5 ) ,在ST T及早搏方面差异无显著性 (P >0 .0 5 )。在心功能方面 ,人巨细胞病毒性心肌炎心室收缩功能、左室射血分数 (LVEF)、左室短轴缩短率 (LVFS)、心脏指数 (CI)与柯萨奇病毒性心肌炎比较差异有显著性 (P <0 .0 1 ) ,心室舒张功能 (E/A)无明显差异。【结论】人巨细胞病毒性心肌炎对心肌的损害程度重于柯萨奇病毒性心肌炎。

Comparative Study of Human Cytomegaloviral Myocarditis and Coxsackie Viral Myocarditis

To study the clinical features of human cytomegaloviral myocarditis (HCMVM).The age of disease onset, electrocardiogram (ECG), myocardial enzyme spectrum and cardiac functions in 29 cases of HCMVM and 52 cases of Coxsackie viral myocarditis (CXVM)were compared clinically.More young infants were involved in HCMVM ; statistical analysis demonstrated the existence of a significant age difference, the numbers of cases suffered from two types of myocarditis were close in preschool age children. The serum creatine kinase-MB(CK-MB) activities and cardiac troponin I, (CTnI) levels in children with HCMVM were obviously higher than those in children with CXVM (P<0.01). Conduction block was the main change reflected on ECG of HCMVM children, showing distinct difference from CXVM (P<0.05); but no significant difference in ST-T wave segment and premature beat was found between two types of myocarditis (P>0.05). As for the heart function, the contractile function of ventricles, left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) and cardiac index (CI) in HCMVM exhibited statistically significant disparity as compared to those in CXVM (P<0.01). However, the diastolic function of ventricles (E/A) in both types of myocarditis was rather similar.Conclusion]The degree of myocardial damage in HCMVM is severer than that in CXVM.