重症急性呼吸综合征患者心肌损害的初步研究

目的　通过对重症急性呼吸综合征 (SARS)患者心肌酶变化的研究 ,探讨SARS患者的心肌损害及其临床意义。方法　依据广东省传染性非典型肺炎病例临床诊断标准 (草案 ) ,选择SARS患者 37例和健康体检者 35例 ,检测血清肌酸激酶、乳酸脱氢酶、AST、肌钙蛋白Ⅰ、肌酸激酶同工酶、肌红蛋白。结果　SARS组肌酸激酶、乳酸脱氢酶、AST(单位均为U/L)明显高于对照组 (分别为 2 85 4 9± 2 6 6 2 1比 10 6 71± 4 3 38;388 5 6± 198 80比 2 0 0 83± 4 4 86 ;71 0 3± 36 14比 2 9 4 3± 8 89,P值均 <0 0 1) ;死亡者均值较存活者高。SARS组肌钙蛋白Ⅰ、肌酸激酶同工酶、肌红蛋白阳性率高于对照组 ,P <0 0 5。病理显示心肌细胞局部变性。结论　SARS患者易合并心肌损害 ,临床收治该病患者时应予以足够的重视。密切监测心脏功能 ,对减少并发症、降低病死率具有重要意义。

Study on the myocardiac injury in patients with severe acute respiratory syndrome

OBJECTIVE: To explore the myocardiac injury in patients with severe acute respiratory syndrome (SARS) and its clinical significance. METHODS: 37 SARS patients fulfilled the Guangdong provincial diagnostic criteria for infectious atypical pneumonia and 35 health controls were investigated. The serum levels of creatine kinase (CK), lactate dehydrogenase (LDH), aspartate transaminase (AST), troponin I (TnI), creatine kinase-MB (CK-MB) and myoglobin (MYO) were measured. RESULTS: CK, LDH and AST levels in patients were higher than those of control group (P < 0.01); furthermore, among patients the levels were higher in fatal cases than in survivors. The positive rates of TnI, CK-MB and MYO in patients were higher than those in controls (P < 0.05). CONCLUSION: The patients with SARS are subject to complicating myocardiac injury. Therefore, careful monitoring of the myocardiac enzyme profiles is of great importance in reducing the complications and mortality in patients with SARS.