支原体肺炎感染患者合并心血管损害临床分析

Clinical analysis of patients with mycoplasma pneumoniae infection complicated with cardiovascular lesions

目的：总结支原体肺炎感染患者合并心血管损害的临床特点及诊治方法。方法对我院收治的42例支原体肺炎感染合并心血管损害患者的临床资料进行分析。结果本组患者均咳嗽（以干咳为主）,伴发热32例,喘息、气急者12例,少量咳痰10例。从发病至出现心血管系统症状时间为4~14天,平均7天。均静脉滴注罗红霉素或阿奇霉素10~20 mg/（kg·d）,好转后改为口服阿奇霉素10 mg/（kg·d）约7~14天；同时均予补充心脏能量合剂,包括1,6-二磷酸果糖、三磷酸腺苷、辅酶Q10、维生素C等治疗9~33天后,临床症状基本消失,心肌酶谱检测恢复正常,心电图基本恢复正常,均治愈出院。结论支原体肺炎患者一般于感染后约1周出现心血管损害表现,血清心肌酶谱检测及心电图有助于诊断,其中CK-MB最为特异性标志物；治疗以应用大环内酯类抗生素为主,辅以营养心肌药物,预后较好。

Objective To summarize the clinical features, diagnosis and treatment of patients with myco-plasma pneumoniae infection complicated with cardiovascular lesions. Methods The clinical data of 42 patients with mycoplasma pneumoniae infection complicated with cardiovascular lesions were retrospectively analyzed. Results All patients had cough （mainly dry cough）. There were 32 cases of fever, 12 cases of wheezing and shortness of breath, and 10 cases of small amount of sputum. The time from onset to cardiovascular system was 4 to 14 days, with an average of 7 days. They all were given intravenous drip roxithromycin or azithromycin 10 mg/（ kgod ） , and changed to oral azithromycin 10 mg/（ kgod） for 7~14 days. At the same time, they were treated with cardiac energy mixture, including 1, 6-diphosphate, adenosine triphosphate, coenzyme Q10, vitamin C and so on. The clinical symptoms disappeared 9 to 33 days after the treatment, and myocardial enzymes tests were back to normal. The elec-trocardiogram returned to normal. Conclusion Cardiovascular lesions generally occur 1 week after infection in pa-tients with mycoplasma pneumoniae. The performance of serum myocardial enzyme detection and ECG can help diag-nose, and CK-MB is the most specific marker. The main application is macrolide antibiotic treatment, supplemented with nutritional cardiac drugs.