急性心肌炎暴发阶段的预测因素

作     者：Lee C. -H. Tsai W. - C. Hsu C. - H. 尹涛(译) 杜媛(校) 

作者机构：不详 Department of Internal Medicine School of Medicine National Cheng Kung University Medical Center 138 Sheng-Li Road Tainan 704 Taiwan 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第9期

页      面：40-40页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：暴发性心肌炎 急性心肌炎 预测因素 临床表现诊断 实验室检查指标 院内死亡率 左室射血分数 重症监护室 

摘      要：Background: Patients who develop fulminant myocarditis often die of sudden car diac arrest, arrhythmia, or severe heart failure soon after onset if they do not receive percutaneous cardiopulmonary support in time. The purpose of this study was to identify the risk factors of clinical symptoms/signs or laboratory findi ngs that could predict the fulminant course of acute myocarditis. Methods and re sults: Thirty-five patients(mean age 28±8 years, 17 males) who had been admitt ed to intensive care unit with the diagnosis of acute myocarditis by clinical pr esentations were retrospectively recruited. They were divided into the fulminant group(n=11) and the non-fulminant group(n=24). Clinical features, laboratory d ata, and images on admission were analyzed. Overall in-hospital mortality was 1 7%(6/35). Mortality was higher in the fulminant group(45%vs. 4%, p=0.027). Mu ltivariate analysis revealed that prolongations of the QRS complex(118±27 vs. 8 8±10 ms, p=0.048) and depressed left ventricular ejection fraction(41±7%vs. 5 7±7%, p=0.027) were the only independent factors significantly associated with the fulminant course of acute myocarditis. Conclusion: The in-hospital mortali ty of acute fulminant myocarditis was high. Prolongations of the QRS complex and depressed left ventricular ejection fraction on admission were independent posi tive predictors for the development of acute fulminant myocarditis.