暴发性心肌炎的相关危险因素分析  

Analysis of risk factors for fulminant myocarditis

作　　者：邢欣悦[1] 田雪[1] 李红[1] XING Xin-yue;TIAN Xue;LI Hong(Department of Emergency, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院急诊危重症中心,北京100029

出　　处：《实用医院临床杂志》2022年第3期13-16,共4页Practical Journal of Clinical Medicine

基　　金：首都卫生发展科研专项(首发2022-1G-2063)。

摘　　要：目的分析导致暴发性心肌炎的相关危险因素。方法回顾性纳入2015年1月至2020年12月于首都医科大学附属北京安贞医院住院诊治的病毒性心肌炎患者84例,根据诊断标准分为暴发性心肌炎组(27例)和非暴发性心肌炎组(57例),比较两组患者临床特征、实验室及影像学化验检查结果,分析可能引发暴发性心肌炎的危险因素。结果单因素分析结果提示,两组间肌酐、谷丙转氨酶、C反应蛋白、同型半胱氨酸、阴离子间隙、肌钙蛋白(TNI)及肌酸激酶同工酶(CK-MB)峰值水平高,白蛋白水平低、室速/室颤、心跳骤停的发生、肺炎支原体感染比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析提示室速/室颤的发生、肌酐、谷丙转氨酶、白蛋白、C反应蛋白、同型半胱氨酸、CK-MB是导致暴发性心肌炎的独立危险因素。结论室速/室颤的发生、肌酐、谷丙转氨酶、白蛋白、C反应蛋白、同型半胱氨酸、CK-MB是导致暴发性心肌炎的独立危险因素。Objective To analyze the risk factors of fulminant myocarditis.Methods A total of 84 patients with viral myocarditis who were hospitalized in our hospital from January 2015 to December 2020 were retrospectively included.According to the diagnostic criteria,the patients were divided into a fulminant myocarditis group(n=27)and a non-fulminant myocarditis group(n=57).Clinical features,and laboratory and imaging results were compared between the two groups.Results Univariate analysis showed that there were differences in creatinine,alanine aminotransferase,C-reactive protein(CRP),homocysteine,anion gap,troponin(TNI),creatine kinase-MB(CK-MB)peak level,albumin,ventricular tachycardia/ventricular fibrillation,cardiac arrest,and mycoplasma pneumoniae infection between the two groups(P<0.05).Logistic analysis further demonstrated that ventricular tachycardia/ventricular fibrillation,creatinine,alanine aminotransferase,albumin,CRP,homocysteine and CK-MB peak level were the independent risk factors for fulminate myocarditis.Conclusion Ventricular tachycardia/ventricular fibrillation,creatinine,alanine aminotransferase,albumin,CRP,homocysteine and CK-MB peak level are the independent risk factors for fulminate myocarditis.

关 键 词：暴发性心肌炎 危险因素 分析 

分 类 号：R542.21[医药卫生—心血管疾病]