火神山医院新型冠状病毒肺炎患者的心电图分析  

The analysis of electrocardiogram in novel coronavirus pneumonia in Huoshengshan hospital

作　　者：王会生 李依阳[3] 青恒臻 张涛 Wang huisheng;Li yiyang;Qing hengzhen;Zhang tao(Department of Special Diagnosis,Huoshengshan Hospital,430070,China;Department of Special Diagnosis,The 923th Hospital of PLA,530021,China;Department of Cardiovasology,The National Hospital of Guangxi Province,530001,China)

机构地区：[1]武汉市火神山医院,430070 [2]联勤保障部队第923医院,530021 [3]广西民族医院,530001

出　　处：《临床心电学杂志》2020年第4期261-264,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨新型冠状病毒肺炎患者的心电图改变,了解新型冠状病毒肺炎对心脏电活动的影响,协助临床诊疗。方法回顾性分析2020年2月5日至3月10日武汉火神山医院住院治疗的新型冠状病毒肺炎(COVID-19)患者,其中做过心电图检查的共280例。收集并统计分析上述患者一般资料、心电图改变及相关实验室检测指标。结果共280例患者,其中男165例(58.9%),女115例(41.1%),年龄21-85岁,中位数年龄53岁,其中普通型67人,重型184人,危重型29人。138例(49.3%)患者存在高血压、糖尿病、冠心病等基础疾病。ST-T改变为最常见的心图改变,占31.1%,其次为心律失常26.9%,以早搏为主7.2%。21例(7.5%)重型患者血清高敏肌钙蛋白(hs-c Tn)升高超过参考值,其中9例(3.2%)明显异常,超过参考值上限10倍,但仅1例(0.4%)诊断急性心肌梗死。重型(75.0%)及危重型(100%)COVID-19患者心电图异常比例明显高于普通型(23.9%)。结论心电图改变在受检COVID-19患者中较普遍,但恶性心律失常少,多为ST-T改变、房性及室性心律失常。重型及危重型心电图异常发病率很高,多见心律失常,普通型多见ST-T改变。合并高血压、糖尿病、冠心病的患者更易感COVID-19。部分重型患者hs-c Tn异常升高,提示心肌损伤,非急性心肌梗死。Objective To investigate the electrocardiogram changes and explore the effect on cardiac electrical activity in new coronavirus pneumonia patients, and in order to assist in clinical diagnosis and treatment. Methods Retrospectively analyzed the COVID-19 patients in Huoshengshan Hospital from February 5 to March 10, 2020. We collected and analyzed the general information, ECG changes and related laboratory indication in all the 280 patients.Results There were 165 male patients(58.9%), 115 females(41.1%), age range from 21 to 85 years old, the median age was 53 years old, in which it included 67 of type common, 184 of type severe and 29 of type dying. There were138 patients(49.3%) had underlying diseases such as hypertension, diabetes and coronary heart disease. ST-T change was the most common change in the all patients, accounting for 31.1%, followed by arrhythmia, the number is26.9%, which was based on premature beat(7.2%). hypersensitive response troponin(hs-c Tn) was higher than reference value in 21(7.2%) patients of type severe, obvious abnormality which 10 times above the upper limit of the reference value in 9(3.2%) patients, but only 1(0.4%) case was diagnosed as acute myocardial infarction. The rates of abnormal ECG between type severe(75.0%) and type dying(100%) was significantly higher than type common(23.9%). Conclusions ECG changes are common in COVID-19 patients, but less malignant arrhythmia, most of it was ST-T change, atrial and ventricular arrhythmia. The incidence of abnormal ECG is very high between type severe and type dying patients, in which arrhythmia is common. Correspondingly ST-T change is usual in type common patients. The persons with high blood pressure, diabetes, coronary heart disease are more predisposed to suffer from COVID-19. In some severe patients, hs-c Tn was very high, which suggest myocardial injury rather than myocardial infarction.

关 键 词：COVID-19 心电图 心肌损伤 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]