发热伴血小板减少综合征患者心电图特点及意义

Characteristics and significances of ECG in patients of severe fever with thrombocytopenia syndrome

目的探讨发热伴血小板减少综合征（SFTS）患者的心电图（ECG）变化及其影响因素和临床意义。方法 对107例SFTS患者的心电图及心肌酶、生化指标进行监测和分析,将病例组分为治愈组、好转组、未愈组及死亡组,比较不同转归患者及门诊查体对照组的差别。结果59例患者出现心电图异常,显著高于对照组（55.14%vs 16.67%;χ^2=30.85,P=0.000）,其中以ST-T改变、窦性心动过缓及房颤发生率最高,与对照组相比差异均有统计学意义（χ^2=7.119、5.1 50、3.998,P=0.008、0.023、0.046）。在SFTS患者中,ECG正常组与异常组相比,LDH、HBDI-I、CK-MB及白蛋白水平差异具有统计学意义,而血钾、钠、钙等电解质水平无显著改变。结论SFTS患者易出现心电图异常,心肌损害、白蛋白下降等可能为重要原因。

Objective To investigate the influence factors and significance of electocardiogram（ECG） changes of severe fever patients with thrombocytopenia syndrome.Methods The ECG,myocardial enzymes and related biochemical parameters in 107 cases with SFTS were analyzed.The patients were divided into cure group,recovery group,stroke group and death group,the difference between patients with different prognosis and clinic examination control group were compared.Results Total of 59 cases of SFTS had abnormal ECG,more than the control group,with significant difference（55.14%vs 16.67%;χ^2 = 30.85,P = 0.000）.ECG abnormal rate of ST-T,sinus bradycardia and atrial fibrillation were the highest in these cases,and there were significant differences between the two groups（χ^2 = 7.119,5.150,3.998;P = 0.008,0.023,0.046）.The levels of LDH,CK-MB,HBDH and albumin had significant difference in abnormal ECG group,compared with normal ECG group in the patients.But no significant difference was found in serum electrolyte,such as potassium,sodium,calcium and so on.Conclusions SFTS patients were with higher risk of abnormal ECG,myocardial injury and albumin reduce may be the important reasons for the abnormity.