类急性心肌梗塞样的暴发性心肌炎临床分析

Clinical Analysis of Acute Myocardial Infarctionlike Fulminant Myocarditis

目的:了解和探讨暴发性心肌炎的心电图改变与临床特征。方法:观察6例心肌酶学异常增高近6～13倍,心电图出现急性心肌梗塞时的坏死性Q波、ST段损伤型改变、ST-T呈单向曲线、“墓碑型”改变,合并各种严重心律失常患者的心电图及临床表现。结果:6例均出现窦性心动过速和心律失常,4例死亡前均表现为左心功能不全。结论:暴发性心肌炎发病急骤,病情险恶,病死率高。但如能及早确诊,病情可得到控制,患者有望获救成功。

Objective：To discuss and understand the changes of electrocardiogram（ECG） and clinical manifestations of Fulminant myocarditis. Method ：The clinical data and ECG figures of 6 patients were sutdied. In all patients ,the plasma levels of myocardial enzyme increased by 6-13 times abnormally and ECG showed necrotic Q,injury type change of ST segment,unldirectional cruve ST-T change and grave stone type change which likes those with acute myocardial infarction. Various kinds of cardia arrhythmias were also found in these patients. Results：Six patients were all sinus tachycardia and cardiac arrhythmias,four patients were all lefe heart insufficiency before death. Conclusion：The mortality of fulminant myocarditis is very high, but it can be controled if confirmed diagnosis could be made early.