19例暴发性心肌炎的临床特征分析  

Analysis of clinical features of 19 cases of fulminant myocarditis

作　　者：韦连芬 黄释丹 雷玲艳 WEI Lianfen;HUANG Shidan;LEI Lingyan(National Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China)

机构地区：[1]广西壮族自治区民族医院,广西南宁530000

出　　处：《临床医学研究与实践》2025年第7期25-28,共4页Clinical Research and Practice

摘　　要：目的探讨暴发性心肌炎的临床症状、超声心动图及心电图的特点及诊治策略。方法通过电子病历系统,收集2018年1月至2024年4月我院收治的19例暴发性心肌炎病例,将其分为未成年组(8例)和成年组(11例)。根据病例的临床资料回顾性分析其临床症状、超声心动图、心电图及临床治疗情况。结果未成年组临床症状中占比前三位分别为发热、消化道症状和卡他性症状;成年组则以心脏症状、发热、卡他性症状和循环灌注不足更为多见。超声心动图检查结果显示,两组中瓣膜返流及左心室增大的占比较高。心电图检查结果显示,未成年组的窦性心动过速(50.0%)、二度以上房室传导阻滞(50.0%)占比更高;成年组则以窦性心动过速(63.6%)、新出现Q波(54.5%)、ST段抬高(54.5%)更为多见。未成年组有7例好转出院,1例因多脏器功能衰竭死亡;成年组有9例好转出院,2例因心脏停搏及心源性休克死亡。结论在暴发性心肌炎的诊治中,应充分发挥临床症状与常规心血管疾病检查项目的诊断价值,实现及时诊断,并尽早开展以生命支持为基础的综合救治。Objective To explore the characteristics of clinical symptoms,echocardiography,electrocardiogram and the diagnosis and treatment strategies of fulminant myocarditis.Methods Through the electronic medical record system,19 cases of fulminant myocarditis admitted in our hospital from January 2018 to April 2024 were collected and divided into underage group(8 cases)and adult group(11 cases).According to the clinical data of the cases,the clinical symptoms,echocardiography,electrocardiogram and clinical treatment were retrospectively analyzed.Results The top three clinical symptoms in the underage group were fever,gastrointestinal symptoms and catarrhal symptoms;cardiac symptoms,fever,catarrhal symptoms and circulatory insufficiency were more common in the adult group.The results of echocardiography showed that the proportions of valvular regurgitation and left ventricular enlargement were higher in the two groups.The results of electrocardiogram examination showed that the proportions of sinus tachycardia(50.0%)and second degree or above atrioventricular block(50.0%)were higher in the underage group;in the adult group,sinus tachycardia(63.6%),new Q wave(54.5%)and ST segment elevation(54.5%)were more common.In the underage group,7 cases improved and discharged,and 1 case died of multiple organ failure;in the adult group,9 cases improved and discharged,and 2 cases died of cardiac arrest and cardiogenic shock.Conclusion In the diagnosis and treatment of fulminant myocarditis,the diagnostic value of clinical symptoms and routine cardiovascular disease examination items should be given full play to achieve timely diagnosis,and comprehensive treatment based on life support should be carried out as soon as possible.

关 键 词：暴发性心肌炎 临床症状 超声心动图 心电图 

分 类 号：R447[医药卫生—诊断学]