成年人病毒性心肌炎急性期心脏肾上腺素受体功能研究

The Study of Cardiac β-adrenergic Recepter Function in Acute Phase of Viral Myocarditis in Adult

目的研究成年人病毒性心肌炎急性期心脏β-肾上腺素受体(β-adrenergic,β-AR)功能。方法利用多巴酚丁胺负荷超声心动图对32例成年病毒性心肌炎患者和32例正常成年人心脏左室收缩末期容量、收缩压与左室收缩末期容量比值(SP/ESV)、射血分数(EF)、左心室短轴缩短率(FS)和左心室后壁增厚离(△PWT%)进行测定。结果用药前除心肌炎组△PWT%高于正常对照组外,其余指标两组无明显的差异;用多巴酚丁胺药物5ug/kg、min后,心肌炎组EF由用药前0.59增加至0.71,FS由0.31增加至0.39,SP/ESV由0.45增加至0.63,△PWT%由19增至56,而对照组EF由0.57增至0.67,FS由0.30增至0.41,SP/ESV由0.42增至0.63,△PWT%由18增至28,上述指标心肌炎组增加幅度要比对照组大(P<0.05),而心肌炎组ESV由38.1降至32.2,对照组由37.2降到31.1,心肌炎组降低幅度大于对照组(P<0.01)。结论病毒性心肌炎患者急性期心脏β-AR功能亢进。

Objective To study the cardiac β-adrenergic receptor function in acute phase of viral myoearditis in adult. Methods Dobutamin stress eehoeardiography was used to measure left ventrieular end systolic volum （ ESV ）, the radio of systotic volume （ sp/esv ）, ejection fraction （ EF）, fractioned shortening （FS） of the heart and change of left ventricular posterior wall thickness（ △PWT% ） in acute phase of viral myocarditis in adult and in normed adult. Results Before the use of dobatamine,except for △kPWT% which was higher in patients with myocarditis than that in normal there was no difference in other indexes between two groups. After the use of 5 μg·kg^-1·min^-1 dobutamine, EF in mgocarditis group increasd from 0.59 before use of dobutamine to 0.71 ,FS from 0.30 to 0.38 ,SP/ESV,from 0.45 to 0.63, △PWT% from 18 to 28. The increasing extent of the above indexes is myocasditis group was higher them that in control group （P〈0.05）. ESV in myocarditis group decreased from38.l to 30.2 ,while in control group decreased from 37.2 to 31.1 ,the decreasing extent of the index is myocarditis group was so higher than that in normal group （P〈O.O1）.Conclusion Cardiac β-AR function in acute phase of viral myocarditis in aduct was hypersensitive.