急性重症心肌炎的临床分析-内科学(心血管病)专业论文.docx

浙江大学硕士学位论文Clinical 浙江大学硕士学位论文 Clinical analysis of acute severe myocarditis Yunlan Ni,Weifang Zhang Department of Cardiology,the First Affiliated Hospital,College of mediciⅡe． Zhcjiang UniversiW,Hangzhou 310003，China Abstract objective To better define the clinical feature and natural history of acute Severe viral myocarditis by analyzing clinical course of patients with acute severe viral myocarditis． Methods The e linical presentation,diagnosis，therapy and prognosis of patients who were admitted in oRr hospital from January 2004 to January 2007 for acute severe viral myocarditis were analy四d retrospectively Results A total of 14 patients witll acute severe viral myocarditis(male 4 and female 10，aged from 16 to 60 years old，with a mean age 40．3士14．1 years)were analyzed．Some patients wesented fife-threatening arthythmia(50％)，heart fallure(21．4％)，cardiogenic shock(7．1％)，even sudden death(7．1％)．Three patients complicated with other organs injury resulting in multiple organ dysfunction．ECG abnormalities，abnormal cchoc砌io鲫hy findings，elevated serum troponin and creatine kinase were presented in these 14 patients．Serum e nteroviral RNA and Coxsackie viral IgM were detected in 4 and 2 patients respectively．Two of 14 patients died in the active phase ofthis disease． Conclusion The clinical feature of patients with acute∞vere viral myocarditis is 3 浙江大学硕士学位论文very 浙江大学硕士学位论文 very serious and varied．Although there am a lot of di秽s吐c and evaluating methods， the positive rate and specificity of some tests ate still low．Supportive care is the first line of trcatmenLincluding hcmodynamic support and inflammation inhibition,and Key words Myocarditis；Diagnostic techniques；Treatment 4 浙江大学硕士学位论文急性重症心肌炎的临床分析 浙江大学硕士学位论文 急性重症心肌炎的临床分析 浙江大学医学院 内科学(心血管病) 硕士研究生 倪昀岚 导 师 章渭方 急性重症病毒性心肌炎(acute severe viral myocarditis)是指各种病毒 感染后引起的严重、广泛的急性心肌损害，突出表现为致命性心律失常、心力衰 竭和(或)心源性休克，甚至猝死。该疾病起病急，进展迅速，如不及时诊断及 治疗，预后凶险。因此，有必要加深对本病的认识。现将我院自2004年1月～ 2007年1月收治的14例重症病毒性心肌炎患者的临床特点、诊治及预后分析如 下。 一、资料与方法 1．一般资料2004年1