病毒性心肌炎患者临床转归及预后因素的随访研究  

Follow-up study of clinical outcomes and prognostic factors in patients with viral myocarditis

作　　者：郭晓辰[1] 张军平[1] 朱亚萍[1] 刘虹[1] 

机构地区：[1]天津中医药大学第一附属医院,天津300193

出　　处：《中华中医药杂志》2014年第5期1626-1629,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金："十一五"国家科技支撑计划(No.2007BAI20B073)~~

摘　　要：目的:研究病毒性心肌炎的1年临床转归并探索其可能的预后因素。方法:详细记录86例临床诊断为病毒性心肌炎患者的资料并随访1年,对病情1年转归结局与患者一般资料、病史、0周中医证候总积分、抗心肌抗体、治疗方法和时间等进行Logistic多元逐步回归分析。结果:最终完成1年随访者共79例,失访7例,其中53.2%的患者临床痊愈,30.4%恢复迁延,16.4%遗留心律失常,未随访到扩张型心肌病和死亡的病例。0周中医证候总积分(OR=0.392)与患者1年后临床痊愈有关,0周中医证候总积分(OR=3.509)、抗心肌抗体(OR=0.643)与患者1年后恢复迁延有关,抗心肌抗体(OR=1.809)与患者1年后遗留心律失常有关。结论:病毒性心肌炎的临床转归基本良好,大多能够得到痊愈或一定程度的恢复。0周中医证候总积分和抗心肌抗体是病毒性心肌炎患者1年预后的危险因素。Objective： To study the one-year clinical outcomes and search for their possible prognostic factors in patients with viral myocarditis （VMC）. Methods： 86 patients who were clinically diagnosed VMC involved in this one-year follow-up. Using the method of Logistic multivariant stepwise regression analysis to compare one-year outcomes of VMC with patients＇ general information, history, traditional Chinese medicine （TCM） syndrome score at zero point, antimyocardial antibody （AMA）, therapeutic method and time, etc. Results： Finally 79 VMC patients completed the one-year follow-up, and the other seven patients were failed to visit. The result of this follow-up showed that 53.2% of the patients fully recovered from illness, 30.4% of the patients were still in convalescence stage, and the other 16.4% had remained arrhythmia. No cases changed into dilated cardiomyopathy or died. TCM syndrome score at zero point （OR=0.392） was significant predictors for fully recovery from VMC one year later. TCM syndrome score at zero point （OR=3.509） and AMA （OR=0.643） were significant predictors for still in convalescence stage one year later. AMA （OR=1.809） was a significant predictor for remained arrhythmia one year later. Conclusion： The clinical outcomes of VMC are well on the whole, for most patients could recover from this illness fully or to some degree. TCM syndrome score at zero point and AMA were risk factors for one-year prognosis of VMC patients.

关 键 词：病毒性心肌炎 转归 预后因素 随访 LOGISTIC回归 

分 类 号：R259[医药卫生—中西医结合]