中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2013年
2期
158-161
,共4页
恙虫病%恙虫病东方体%心脏损伤%预后
恙蟲病%恙蟲病東方體%心髒損傷%預後
양충병%양충병동방체%심장손상%예후
Tsutsugamushi disease%Orientia tsutsugamushi%Heart injury%Prognosis
目的 探讨恙虫病并发心脏损伤的临床表现及影响预后的因素.方法 回顾性分析1985年6月至2012年8月本院收治的200例恙虫病患者的临床资料,包括主要临床表现、血清外斐试验、心肌酶谱和心电图检查结果等.所有患者按确诊时间长短分为确诊时间＜7d组、确诊时间7～13d组和确诊时间≥14d组3组,按年龄分为＜60岁组和≥60岁组2组,分析患者确诊时间和年龄对患者心脏损伤及预后的影响.结果 200例恙虫病患者大多数出现符合恙虫病的典型临床表现,其中33例(16.5％)出现心悸、胸闷,20例(10.0％)发生急性左心功能衰竭;153例(76.5％)出现1项或多项心肌酶活性升高,以乳酸脱氢酶(LDH)升高最常见;111例(55.5％)出现心电图异常,少数患者发生高危性心律失常.与确诊时间≥14 d组比较,确诊时间＜7d组患者的死亡比例显著降低(1.5％比15.4％,P＜0.05).与年龄＜60岁组比较,年龄≥60岁组患者心电图异常及死亡比例显著升高(64.7％比48.7％,12.9％比2.6％,均P＜0.05).结论 恙虫病患者并发心脏损伤的比例较高,其预后与确诊时间和患者年龄有关联.
目的 探討恙蟲病併髮心髒損傷的臨床錶現及影響預後的因素.方法 迴顧性分析1985年6月至2012年8月本院收治的200例恙蟲病患者的臨床資料,包括主要臨床錶現、血清外斐試驗、心肌酶譜和心電圖檢查結果等.所有患者按確診時間長短分為確診時間＜7d組、確診時間7～13d組和確診時間≥14d組3組,按年齡分為＜60歲組和≥60歲組2組,分析患者確診時間和年齡對患者心髒損傷及預後的影響.結果 200例恙蟲病患者大多數齣現符閤恙蟲病的典型臨床錶現,其中33例(16.5％)齣現心悸、胸悶,20例(10.0％)髮生急性左心功能衰竭;153例(76.5％)齣現1項或多項心肌酶活性升高,以乳痠脫氫酶(LDH)升高最常見;111例(55.5％)齣現心電圖異常,少數患者髮生高危性心律失常.與確診時間≥14 d組比較,確診時間＜7d組患者的死亡比例顯著降低(1.5％比15.4％,P＜0.05).與年齡＜60歲組比較,年齡≥60歲組患者心電圖異常及死亡比例顯著升高(64.7％比48.7％,12.9％比2.6％,均P＜0.05).結論 恙蟲病患者併髮心髒損傷的比例較高,其預後與確診時間和患者年齡有關聯.
목적 탐토양충병병발심장손상적림상표현급영향예후적인소.방법 회고성분석1985년6월지2012년8월본원수치적200례양충병환자적림상자료,포괄주요림상표현、혈청외비시험、심기매보화심전도검사결과등.소유환자안학진시간장단분위학진시간＜7d조、학진시간7～13d조화학진시간≥14d조3조,안년령분위＜60세조화≥60세조2조,분석환자학진시간화년령대환자심장손상급예후적영향.결과 200례양충병환자대다수출현부합양충병적전형림상표현,기중33례(16.5％)출현심계、흉민,20례(10.0％)발생급성좌심공능쇠갈;153례(76.5％)출현1항혹다항심기매활성승고,이유산탈경매(LDH)승고최상견;111례(55.5％)출현심전도이상,소수환자발생고위성심률실상.여학진시간≥14 d조비교,학진시간＜7d조환자적사망비례현저강저(1.5％비15.4％,P＜0.05).여년령＜60세조비교,년령≥60세조환자심전도이상급사망비례현저승고(64.7％비48.7％,12.9％비2.6％,균P＜0.05).결론 양충병환자병발심장손상적비례교고,기예후여학진시간화환자년령유관련.
Objective To explore the clinical manifestations and prognostic factors of cardiac injury in patients with tsutsugamushi disease.Methods The clinical data of 200 patients with tsutsugamushi disease who were admitted to our hospital between June 1985 and August 2012 were retrospectively analyzed,including the clinical manifestations,Weil-Felix test,myocardial enzyme profiles and electrocardiogram,etc.Patients were allocated based on the time from onset to confirmation of diagnosis (groups ＜7 d,7-13 d and ≥14 d) and the age (groups ＜60 years and ≥60 years) for determination of their effects on cardiac injury and the prognosis.Results Of 200 cases with tsutsugamushi disease mostly presented with typical clinical manifestations,33 (16.5％)complained of palpitation and chest distress,20 (10.0％) were accompanied by acute left heart failure,153(76.5％) had an elevation of one or more cardiac enzymes as predominated by increasing of lactate dehydrogenase,and 111 (55.5％) showed aberrant electrocardiogram with a minority developed into high-risk arrhythmia.Patients in the ＜7 d group had a significant lower mortality than those in the ≥14 d group (1.5％ vs 15.4％,P＜0.05).The ≥60 year group was characterized by a significantly higher probability of aberrant electrocardiogram and mortality than the ＜60 year group (64.7％ vs 48.7％ and 12.9％ vs 2.6％,both P＜0.05).Conclusion Patients with tsutsugamushi disease have a high incidence of cardiac injury,and the prognosis is related with the age and the time from onset to confirmation of diagnosis.
