SARS病人的心脏损害及其预后

The Damages and Prognosis of Severe Acute Respiratory Syndrome (SARS) on the Heart

目的 探讨SARS对病人心脏的影响。方法 收集急性期和恢复期SARS病人的临床、实验室和物理检查资料进行统计分析。结果 急性期89例住院病人均有胸闷、气促、心悸、乏力等症状 ,心率(92 .5± 18.6) /min。 3 8例病人有至少一项心肌酶指标增高。其中多脏器功能衰竭 4例 ,死亡 4例。 5 1例未升高者中多脏器功能衰竭 2例 ,死亡1例。恢复期 76例病人中 ,胸痛 3 8例 ,胸闷 5 4例 ,气短 5 7例 ,心悸 5 1例。静息心率(65～ 85 ) /min ,有 3 5例轻微活动后心率大于 10 0 /min。结论 SARS可引起心脏的多样损害 ,可能与病毒直接侵犯心肌、毒素对心肌的损害、免疫机制及严重的低氧血症所致的心肌损伤有关。SARS对心脏损害多预后良好。

Objective To evaluate the effects of severe acute respiratory syndrome (SARS) on the heart.Methods 89 patients in acute phase and 76 patients in recovery phase were analyzed after collecting their clinical data.Results In acute phase, all the 89 patients had symptoms such as chest pressure, dyspnea, palpitation and dizziness. 38 cases got a rise in serum cardiac markers, 4 cases developed to multiple organ dysfunction syndrome (MOSF) and 4 cases died in group with abnormal serum cardiac markers. Compared to the group with normal serum cardiac markers, the multiple organ dysfunction syndrome and mortality had significant difference with those in the group with abnormal serum cardiac markers. In recovery phase, of the 76 cases, 38 cases got chest pain,54cases chest pressure,57cases dyspnea,51cases palpitation with rest heart rate 65-85bpm and in 35 cases,the active heart rate over 100bpm.Conclusion Cardiac lesions were found in part of cases with SARS and cardiac lesions were of variety. The mechanism of cardiac lesions may be direct injury on myocytes by virus, caused by a toxin, as a result of infection-induced immune reaction or autoimmunity and severe hypoxidosis. The prognosis of heart damage affected by SARS was well.