新型冠状病毒肺炎患者心肌损害的初步临床研究  

Preliminary Study of Myocardial Damages in COVID-19 Patients

作　　者：李翠芝[1] 李美瑜[1] 李景隆[1] 甘露 张影[1] 黄煌[1] LI Cuizhi;LI Meiyu;LI Jinglong;GAN Lu;ZHANG Ying;HUANG Huang(Guangzhou Eighth People’s Hospital,Guangzhou Medical University,Guangzhou 510440,China;不详)

机构地区：[1]广州市第八人民医院,广东广州510440

出　　处：《现代医院》2020年第10期1525-1528,共4页Modern Hospitals

基　　金：广东省医学科学技术研究基金项目(A2020329)。

摘　　要：目的探讨新型冠状病毒肺炎是否导致心肌损害。方法总结84例临床资料比较完整的COVID-19患者血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)和肌钙蛋白I(cTnI)活性的变化规律。并对部分COVID-19患者的心电图检查以及胸部CT检查进行回顾性分析。结果COVID-19患者血清AST活性在病程第1~2周开始升高,但升幅不大在病程第4周时开始下降。发热期的血清CK活性升高,退热后1周恢复正常。病程第1周少部分患者CK-MB和cTnI升高,且升幅较小,除1例患者,第3周均降至正常水平。COVID-19患者血清LDH升高与肺损害呈明显相关。部分患者心电图有一过性改变。结论COVID-19患者AST、ALT、CK和LDH病程中呈一过性的升高,其主要来源并非心肌组织。少部分患者CK-MB和cTnI升高但升幅较小,且很快降至正常水平。SARS-CoV-2可导致心肌损害,但程度较轻。Objective To explore the myocardial damages patients infected with Coronavirus Disease 2019( COVID-19). Methods To analyze the changes of AST,ALT,CK,LDH,CK-MB and c Tn I in 84 COVID-19 patients whose clinical data were complete and to analyze retrospectively ECG and chest CT in some patients with COVID-19. Results A slight increase of AST in COVID-19 patients was observed in the first 1-2 weeks and they began to decrease in the fourth week during the course of disease.Active CK in serum of the COVID-19 patients rose when they were in fever period and the CK level returned to normal within a week after the fever was gone. A slight increase of CK-MB and c Tn I in only small part of COVID-19 patients was observed in the first week and they returned to normal in the third week except one patient. There as a significant correlation between the increase of LDH level and the extent of damage to the lungs in COVID-19 patients. Abnormal electrocardiograms were noticed in some patients. Conclusion There were transient increases of AST,ALT,CK and LDH in COVID-19 patients,but the increases only have a slight correlation to myocardial lesion. A slight increase of CK-MB and c Tn I in only small part of COVID-19 patients was observed and they soon dropped to normal level. A mild myocardial damage was observed in COVID-19 patients.

关 键 词：新型冠状病毒 新型冠状病毒肺炎 心肌 

分 类 号：R541[医药卫生—心血管疾病]