肾综合征出血热心电图、心肌酶和内源性洋地黄物质的变化  

The Changes of the Electrocardiogram and Serum Myocardial Enzymes and Endogenous Digitalis-like Substance in Hemorrhagic Fever with Renal Syndrome

作　　者：任金华[1] 张元度 韦炳远 戎云清 孙志坚[2] 朱公文 

机构地区：[1]江苏省丹阳市人民医院,丹阳212300 [2]南京医科大学第一附属医院,南京210029 [3]安徽省凤台县人民医院,凤台232100

出　　处：《热带医学杂志》2002年第4期373-375,共3页Journal of Tropical Medicine

摘　　要：本文报道了肾综合征出血热 (HFRS)心电图、心肌酶和内源性类洋地黄物质 (EDLS)的变化 ,结果发现重症组大多呈心肌损害的异常波形如心律失常、Q T间期延长、低电压、Ⅰ°～Ⅱ°房室传导阻滞、ST T波改变等 ;轻症组以窦性心动过速或过缓 ,偶见异位节律及ST T波改变。两组患者血清天门冬氨酸转移酶 (AST)、乳酸脱氢酶(LDH)、肌酸磷酸激酶 (CPK)活性于病程前 4w均见升高 ,重症组比轻症组更明显 ,其变化趋势与血尿素氮 (BUN)的变化曲线大体相似 ;血清EDLS在轻症组基本正常 ,重症组于病程前 4w则明显下降 ,以发热期和低血压期为最著。检查心电图、心肌酶可了解心脏损伤的程度 ,重型患者于病程极期适量补充洋地黄制剂可改善心功能。This paper is to investigate the changes of the electrocardiogram, serum myocardial enzymes and endogenous digitalis like substance (EDLS)in hemorrhagic fever with renal syndrome (HFRS). The results showed that most of severe patients presented abnormal electrocardiogram such as arrhythmia, prolonged Q T interval, hypopotentia, Ⅰ°～Ⅱ° A V black, and unusual ST T waves, which not frequently occurred in moderate group. The activities of serum aspartate aminotransferase(AST), lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) were markedly increased in both moderate and severe group, but they were higher in severe group than in moderate group. The curves of these enzymes by and large simulated that of blood urea nitrogen (BUN). Serum EDLS was basically normal in moderate group, while it reduced significantly in severe group during the first four phases with a peak value at hypotensive or oliguric stage. We conclude that the detection of electrocardiogram and serum myocardial enzymes in HFRS patients may be benefit for evaluating the degree of myocardial damage, and the appropriate supplement of digitalis at the critical stage of this disease may improve heart function.

关 键 词：肾综合征出血热 内源性类洋地黄物质 心电图 心肌酶 

分 类 号：R512.8[医药卫生—内科学]