30例急性重症心肌炎患者的临床特征及治疗策略  

Clinical features and treatment strategies in 30 patients with acute fulminant myocarditis

作　　者：黄煜[1] 林军华[1] 吴佳易[1] 鄢晓平[1] 彭亚飞[1] 

机构地区：[1]福建医科大学附属协和医院心内科,福州350001

出　　处：《临床心血管病杂志》2014年第2期104-107,共4页Journal of Clinical Cardiology

摘　　要：目的:总结急性重症心肌炎(AFM)的临床特征与治疗策略。方法:对我院2005-08-2013-02收治的30例AFM患者的临床资料进行回顾性分析。结果:30例患者中,10例治愈,14例好转,6例死亡。6例急性期死亡患者均在入院后48h内死亡,并伴有心源性休克。结论:AFM的早期诊断和治疗极具挑战性。中老年患者心电图酷似心肌梗死样改变,极易误诊,超声心动图在纠正误诊中具有重要价值。早期冠状动脉造影同样十分重要。一旦确诊,应积极采取综合治疗,及时给予机械辅助治疗将显著改善预后。Objective：To investigate the clinical features,treatment strategies and prognosis in patients with acute fulminant myocarditis（AFM）.Method：Data of 30consecutive AFM patients admitted to our hospital from August 2005to February 2013 were analysed.Result：Among 30cases,10cases were cured,14cases were improved and 6cases were dead.All 6dead cases died at acute stage inside 48hours,and all accompanied cardiogenic shock.Conclusion：Early diagnosis and treatment are extremely challenging in AFM.Middle-aged patients with myocardial infarction-like ECG changes are very easily misdiagnosed as acute myocardial infarction,meanwhile echocardiography has important value on the diagnosis of AFM correctly.Early coronary angiography is also very important.Integrated measures particular mechanical circulatory support should be performed positively, which would greatly improve the prognosis outcome.

关 键 词：重症心肌炎 心源性休克 超声心动图 冠状动脉造影 机械支持治疗 

分 类 号：R542.2[医药卫生—心血管疾病]