急性重症病毒性心肌炎40例临床分析

目的探讨急性重症病毒性心肌炎的发病特点、治疗和预后。方法回顾分析2002年7月—2012年4月本院收治的40例急性重症病毒性心肌炎的临床资料。结果 40例急性重症病毒性心肌炎病人中有明确病毒感染史者26例;临床表现多样化,以心律失常或心力衰竭引起的相关症状为主诉的相对多见;心电图以恶性室性心律失常及Ⅲ度房室传导阻滞多见,超声心动图多数提示室壁运动减弱,左心收缩或舒张功能异常;血清肌钙蛋白-I、磷酸肌酸激酶CK-MB均明显升高。30例治愈出院,2例遗留心律失常,8例死亡。结论急性重症病毒性心肌炎起病急,进展快,急性期病死率较高,但如果临床足够重视,早期识别,并进行积极有效的综合治疗,可使大部分患者完全恢复。

Clinical analysis of 40 patients with acute severe viral myocarditis

Objective To study the characteristics,treatment and prognosis of acute severe viral myocarditis(ASVMC). Methods The data of 40 inpatients with ASVMC from July 2002 to April 2012 were reviewed.Results A total of 26 cases of 40 patients with ASVMC were confirmed to have clear virus infection history.Clinical manifestations of them were multiplex;symptoms related to the chief complaints caused by arrhythmia and heart failure were mostly found;malignant ventricular arrhythmia III,atrioventricular block and decreased ventricular wall motion in echocardiography were usually observed;the shrinkage or diastolic of left heart function was abnormal;serum calcium muscle protein-I,phosphoric acid creatine kinase and CK-MB were increased significantly.Thirty patients were cured and discharged,2 left with arrhythmia,and 8 died.Conclusions ASVMC is characterized by acute onset,rapid progression and high mortality in the acute phase.If the sufficient attention,early recognition and positive and effective treatment are given,most of the patients could recover entirely.