危重型新型冠状病毒肺炎患者的心血管系统表现  

Manifestations of cardiovascular system in patients with COVID-19 of critical type

作　　者：狄文成[1,2] 代永斌 徐标 DI Wencheng;DAI Yongbin;XU Biao(Department of Cardiology,Nanjing Drum Tower Hospital,Clinical College of Nanjing Medical University,Nanjing 210003,CHINA)

机构地区：[1]南京医科大学鼓楼临床医学院心内科,江苏210003 [2]深圳市第三人民医院心内科

出　　处：《江苏医药》2020年第7期716-718,共3页Jiangsu Medical Journal

摘　　要：目的分析危重型新型冠状病毒肺炎(COVID-19)患者的心血管系统表现。方法回顾性分析15例危重型COVID-19患者(危重型组)和15例重型COVID-19患者(重型组)的心血管系统相关临床资料。结果危重型组患者均出现心率增快(最高104~145次/分),出现升高的肌红蛋白5例、肌酸激酶(CK)6例、肌酸激酶同工酶(CK-MB)4例、心肌肌钙蛋白I(cTnI)5例和氨基末端脑钠肽前体12例。2例胸部X射线示心影增大,均发生在肺部病变加重时;其中,1例心影增大呈一过性,4 d后逐渐恢复。心脏超声提示4例出现右心房、右心室扩大,6例出现肺动脉压增高,2例左心室射血分数下降。与重型组相比,危重型组CK、CK-MB和cTnI水平升高的患者比例较高(P<0.05)。结论危重型COVID-19患者除出现肺部损伤外,心脏也可受累。Objective To analyze the manifestations of cardiovascular system in the patients with coronavirus disease 2019(COVID-19)of critical type.Methods The clinical data of cardiovascular system in 15 patients with COVID-19 of critical type(group A)and 15 COVID-19 patients of severe type(group B)were retrospectively analyzed.Results The HR was increased in all the patients in group A with highest range of 104-145 times per minute.The patients in group A had increased levels of myoglobin in 5 cases,creatine kinase(CK)in 6 cases,creatine kinase isoenzyme(CK-MB)in 4 cases,cardiac troponin I(cTnI)in 5 cases,and N-terminal pro-brain natriuretic peptide in 12 cases.Chest X-ray showed the enlargement of heart shadow in 2 cases,which occurred at the time of aggravation of lung lesions.The enlargement of heart shadow in 1 case was transient and gradually recovered 4 days later.Echocardiography showed that the right atrium and right ventricle were enlarged in 4 cases,pulmonary artery pressure was increased in 6 cases,and left ventricular ejection fraction was decreased in 2 cases.Compared with group B,the percentages of the patients with increased CK,CK-MB and cTnI were higher in group A(P<0.05).Conclusion Besides lung injury,the heart is also affected in the patients with critical COVID-19.

关 键 词：新型冠状病毒肺炎 心肌损伤 

分 类 号：R563[医药卫生—呼吸系统]