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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周内收住入院的 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 10 0次 /min 3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
Objective To analyze the effects of severe acute respiratory syndrome (SARS) on the heart. Methods Fifteen patients with SARS admitted to hospital within 1 week of onset were enrolled and their clinical data such as chest radiograph, electrocardiogram, blood routine and biochemical examination, percutaneous arterial oxygen saturation and heart rate were collected during hospitalization. According to chest radiographs of unilateral lung involvement in 4 cases and bilateral lung involvement in 11 cases of two groups for clinical analysis and comparison. Results (1) Among the patients with unilateral pulmonary lesion, 1 case of fever lasting more than 1 week, no hypoxemia and hypoalbuminemia appeared, no chest X-ray enlargement; while in patients with bilateral pulmonary lesion , Fever duration of more than 1 week in 7 cases, of which 5 patients with hypoxemia, 7 patients with hypoalbuminemia, 6 patients had a transient enlargement of the heart, including 3 cases showed a large right atrium Lord, 3 cases of total heart enlargement, accompanied by obvious pulmonary artery prominent in 2 cases, the change of his heart shadow is proportional to the degree of lung lesions. 2 cases of creatine kinase appeared transiently increased. (2) The heart rate of most patients in two groups tended to increase gradually. The electrocardiogram examination after 3 weeks of onset showed that the heart rate exceeded 10 0 beats / min in 3 cases, all of them were sinus heart rate, and only 1 patient had low T wave , Did not find premature beats. Conclusion SARS has some damage to the heart, and its mechanism may be related to the direct damage of myocardium besides the degree of pulmonary lesion