40例登革热合并心肌损伤患者的临床特征

myocardial injury in 40 patients with dengue fever

目的 探讨登革热合并心肌损伤的临床特点,提高对该病的诊治水平.方法 对398例登革热患者进行临床观察、心肌酶谱检测及心电图检查分析.结果 398例登革热患者中出现心肌酶谱异常40例(10.1%),表现为肌酸激酶同工酶(ck-mb)、肌酸激酶(ck)、乳酸脱氢酶(ldh)、α-羟丁酸脱氢酶(α-hbdh)和ast升高,其中对5例患者同步检测肌钙蛋白t(ctnt),结果为阳性.40例心肌酶升高患者中有34例心电图检查异常,其中以窦性心动过缓最常见,其次为st或t波改变,部分患者还可出现两种以上的心电图改变.结论 登革病毒感染可并发心肌损伤,临床上要结合心肌酶谱改变及心电图检查进行诊断分析,该并发症的病程多为自限性,预后良好. abstract： objective to investigate the myocardial injury in patients with dengue fever. methods three hundred and ninety-eight patients with dengue fever were included in the study. blood myocardial enzyme spectrum and electrocardiography were examined in all patients. results abnormal myocardial enzyme spectrum was detected in 40 patients ( 10. 1% ), including the elevation of blood ck-mb, ck, ldh, α-hbdh and ast levels and increased ctnt levels were also detected in 5 patients. in these 40 patients, 34 showed abnormal electrocardiogram. sinus bradycardia was the most common complication, other complications including st or t wave changes. some patients had more than two kinds of electrocardiogram abnormalities. conclusion dengue vires infection may induce myocardial injury, which suggests that examinations for myocardial enzyme spectrum and electrocardiography are necessary.