恙虫病并发心脏损害37例临床研究

目的总结恙虫病并发心脏损害的临床特点。方法对恙虫病并发心脏损害37例进行分析。结果本组病例具备恙虫病四大临床特征(高热、皮疹、焦痂或溃疡、淋巴结肿大)外,同时有胸闷、心悸、气促。血清外斐反应OXk1:160-1:2560不等,病原体分离3例获恙虫病东方体。心电图显示:窦性心动过速7例,窦性心动过缓10例,ST-T改变9例,房性早搏、室性早博各5例,房颤2例,低电压16例,I-II度房室传导阻滞11例,心肌酶均升高为2倍以上。用氯霉素抗病原,营养心肌,对症、支持治疗均痊愈。结论恙虫病并发心脏损害临床常见,正确、合理、及时、有效的治疗,预后良好。

Thirty-seven Cases of Tsutsugamushi Disease Complicated With Heart Injury

Objective To summarize the clinical characteristics of orientia tsutsugamushi disease complicated with heart injury.Methods 37 tickettsia tsutsugamushi patients complicated with heart injury were analysed.Results Patients in this group all had 4 major characteristics of tsutsugamshi disease(chigh fever,skin rash,eschar or ulcer and lymph nodes enlargement).besides they also had tightness of chest,palpitation and dyspnia.Weil-Felix reactions of blood sera OXk positive from 1:160 to 1:2560,Pathogen separation showed orientia tsutsugamushi in 3 cases.Electrocardiograms showed sinus tachycardia 7 cases,sinus bradycardia 10 cases,changes of ST-T 9 cases,atrial extrasystal and ventricular extrasystol each 5 cases,auricular fibiillation 2 cases,low voltage 16 cases I-II grade A-V 11 cases.serum murkers of cardial Damaye in all cases increased 2 times above normal.chloramphenicol were used against the pathogens together with heart nutrients,symptomatic and supportive treatments.All cases were cured.Conclusion tsutsugamushi diseases complicated with heart injury are commonly seen clinically,proper timely and effective treatment can care the pafients with good prognosis.