急性重症病毒性心肌炎首诊症状和临床分析

Initial symptoms and clinical analysis on acute severe viral myocarditis

目的分析、总结53例急性重症病毒性心肌炎（SVM）的首诊症状和临床特征及转归。方法收集1999年3月至2007年6月临床诊断的急性重症病毒性心肌炎53例。男33例，女20例，年龄12—39岁，平均（26±14）岁。分析归纳SVM的首诊症状及临床经过。结果急性重症病毒性心肌炎首诊症状为晕厥、气促、胸痛者多，临床表现多样，病程凶险，心肌酶升高持续时间长，但无心肌梗死时的酶峰变化，少数患者发展为扩张型心肌病。结论急性重症病毒性心肌炎表现多样，病程凶险，但仍以心脏表现为主，临床表现和客观的辅助检查指标是诊断该病的重要依据。

Objective Initial symptoms , clinical manifestations and turnover on 53 cases of acute severe viral myocarditis were analysed and summarized. Methods 53 cases of acute severe viral myocarditis diagnosed from Mar 1999 to Jun 2007 were collected to summarize the initial symptoms and clinical course , including 33 cases of male and 20 cases of female, aged from 12 -39 （26 ± 14） ages. Results Manifestations of acute severe viral myocarditis varied. Apopsychia, anhelation and chest pain were observed as initial symptoms. Myocardial enzymes incresed for a long time, but without peak as myocardial infarction occurred, while only a few patients developed to dilated cardiomyopathy. Conclusion Manifestations of acute severe viral myocarditis are variable and develop quickly, but mainly on cardiac changes. Diagnosis of acute severe viral myocarditis depends mainly on patient＇s clinical manifestation and objective evidence.