成年女性急性心肌炎的临床特点分析  

Analysis of clinical characteristics of adult woman with acute myocarditis

作　　者：宁尚秋[1] 伊比然恨 尼玛 刘文娴[1] 任燕龙[1] 何卫红[1] 康铁朵[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科、心血管疾病精准医学北京实验室,100029 [2]拉萨市人民医院心内科

出　　处：《心肺血管病杂志》2017年第5期334-337,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都卫生发展科研专项项目(首发2016-3-7031)

摘　　要：目的:探讨成人女性急性心肌炎的临床特点,为临床诊治提供参考。方法:回顾性分析北京安贞医院和拉萨市人民医院2010年1月至2015年12月,诊断为急性心肌炎的年龄超过18周岁的患者共108例,分为两组,一组为女性急性心肌炎组,另一组为男性急性心肌炎组,比较两组的临床特点和转归等。结果:女性急性心肌炎共有35例(32.4%),男性共有73例(67.6%),女性与男性比例为1∶2.1。女性平均年龄(31.5±12.6)岁,男性平均年龄(26.3±8.4)岁,两组间差异有统计学意义(P=0.011)。女性急性心肌炎患者入院时收缩压[(101±19)vs.(114±16)mm Hg,1mm Hg=0.133k Pa,P=0.000]和舒张压为[(64±11)vs.(72±12)mm Hg,P=0.001]与男性组相比差异有统计学意义。女性表现为急性暴发性心肌炎的患者有15例(42.9%),男性有13例(17.8%),两组相比差异有统计学意义(P=0.009)。女性急性心肌炎患者使用有创呼吸机、持续肾脏替代治疗和ECMO辅助比例明显比男性增多,两组差异均有统计学意义。住院期间并发心源性休克在女性急性心肌炎组为8例(22.9%),男性急性心肌炎组为2例(2.7%),两组间差异有统计学意义(P=0.002)。住院期间死亡女性急性心肌炎组为4例(11.4%),男性急性心肌炎组为2例(2.7%),两组间差异有统计学意义(P=0.037)。女性急性急性心肌炎组住院时间为13.0(5.0,17.0)d,男性急性心肌炎组住院时间为9.0(7.0,12.5)d,两组间差异有统计学意义(P=0.036)结论:成人女性与男性相比不易感染急性心肌炎。女性急性心肌炎起病急,病情重,住院期间心源性休克和死亡的发生率较男性相对较高,心脏机械辅助有效,预后良好。Objective：The purpose of this study was to report the outcome of adult women with acute myocarditis in our hospital, in order to provide reference for clinical diagnosis and treatment. Methods： A ret- rospective analysis of Beijing Anzhen Hospital during January 2002 to December 2015 and Lhasa People＇ s Hos- pital during January 2010 to December 2015for the diagnosis of acute myocarditis were 108 cases, divided into two groups, one group of female （female group） , another group of male （male group）. The clinical features, laboratory examination, treatment and prognosis were compared between the two groups. Results： The total of 35 case（32, 4% ） female with acute myoearditis, and total of 73 case （ 67. 6% ） male, the sex ratio was 1 ： 2. 1. The average onset age of patients with female group and male group were different [ （31.5 ± 12. 6） vs. （26. 3 ±8,4） years, P =0. 011]. There was a significant difference between the two group in patients of systolic blood pressure on admission [ （ 101 ± 19）vs. （ 114 ＋ 16） mmHg, P =0. 000] , diastolic blood pressure on admission [ （64 ± 11 ） vs. （72 ± 12） mmHg, P =0. 001 ] , and total number of acute fulminant myocarditis [ 15 （42.9%）vs. 13（ 17. g% ）, P = 0. 009 ）]. There was a significant difference in female myearditis using inva-sive ventilation, continuous renal replacement therapy and ECM0. Female myocarditis patients were significantly more at risk for cardiac shock than male during hospitalization （ P = 0. 002）. Female myocarditis patients exhibited in particular a higher risk of mortality during hospitalization. （ P = 0. 037 ） Conclusion. Woman are significantly less susceptible to acute myocarditis than man. Female myocarditis has acute onset and rapid progression. The incidence of cardiac shock and mortality during hospitalization was significantly high. Mechanical support can be very favourable. Female myocarditis is associated with excellent short-term prognosis.

关 键 词：急性心肌炎 女性 临床特点 

分 类 号：R54[医药卫生—心血管疾病]