老年登革热患者的心脏表现  

Cardiac Performance in Elderly Patients with Dengue Fever

作　　者：童裕维[1] 李莹莹[1] 吕明芳[1] 张复春[2] TONG Yu-wei;LI Ying-ying;LV Ming-fang;ZHANG Fu-chun(Guangzhou Eighth peiple＇s Hospital,Guangzhou 510060,China)

机构地区：[1]广州市第八人民医院内科,510060 [2]广州市第八人民医院感染科,510060

出　　处：《岭南急诊医学杂志》2018年第4期318-320,336,共4页Lingnan Journal of Emergency Medicine

基　　金：广东省医学科学技术研究基金项目(A2015610)

摘　　要：目的:分析老年登革热患者的临床和实验室资料,探讨老年登革热患者的心脏表现。方法:回顾性分析广州市第八人民医院2014-2016年收治的116例65岁以上老年登革热患者,以同期收治的65岁以下登革热患者作为对照,比较两组的临床特点、心脏表现和心肌损伤标记物水平。结果:老年登革热患者合并高血压、冠心病、糖尿病和其他基础疾病的比例显著增多,急性心衰和心律失常发生率显著增加(分别为6.9%和55.2%),心脏超声异常的比例虽未有显著增多,但心脏结构和血流异常更为严重。两组病毒分型无差别,仅1例死亡。老年组脑钠肽升高和肌红蛋白阳性比例显著增高(分别为14.7%和12.9%),肌钙蛋白仅1例阳性。结论:老年登革热患者合并基础疾病明显增多,更容易发生急性心衰和严重的心律失常,心脏超声结构和血流异常更为严重,但总体预后良好。脑钠肽升高和肌红蛋白阳性明显增多,与临床表现相符。Objective：To analyze the clinical and laboratory data of elderly patients with dengue fever,and to explore the cardiac performance of elderly patients with dengue fever. Methods：A retrospective analysis of 116 cases of dengue fever in the elderly aged over 65 from 2014-2016 in Guangzhou No. 8 People.s Hospital was made. The clinical features,cardiac manifestations and myocardial injury markers were compared with control group patients under the age of 65 who were treated in the same period. Results：The proportion of elderly patients with dengue fever complicated with hypertension,coronary heart disease,diabetes and other underlying diseases increased significantly. The incidence of acute heart failure and arrhythmia increased significantly（6.9% and 55.2% respectively）. Although the rate of abnornal cardiac ultrasound did not increase significantly,the abnornal cardiac structure and blood flow were more serious in elderly group. There were no difference in virus parting and only one death case. The proportion of BNP elevation and positive myoglobin in the elderly group increased significantly（14.7% and 12.9%,respectively）,and positive troponin only in 1 case. Conclusions：The incidence of underlying diseases,acute heart failure and serious arrhythmias were higher in elderly patients with dengue fever,and the abnornal structure and blood flow of heart were more serious,but the overal prognosis were good. The increasements of BNP elevation and positive myoglobin were in accordence with the clinical manifestations.

关 键 词：登革热 老年患者 心脏表现 

分 类 号：R512.8[医药卫生—内科学]