24h肌钙蛋白T下降率对ECMO治疗的急性暴发性心肌炎患者预后的影响

Effect of troponin T decrease rate within 24h on the prognosis of patients with acute fulminant myocarditis treated with extracorporeal membrane oxygenation

目的本研究分析经体外膜肺氧合(ECMO)治疗的急性暴发性心肌炎患者肌钙蛋白T下降率在存活组和死亡组之间的差异。方法回顾性分析2015年4月至2018年12月在本院接受ECMO治疗的急性暴发性心肌炎患者的临床资料,根据出院存活情况分为存活组和死亡组,比较两组间24h、48h及72h肌钙蛋白T下降率。结果18例接受ECMO治疗的急性暴发性心肌炎患者被纳入本研究,平均年龄为31岁,其中15例存活,3例死亡,存活率83.3%。存活组在24h肌钙蛋白T下降率上高于死亡组(49.36%vs59.57%,P<0.05),差异有统计学意义;而在48 h肌钙蛋白T下降率(57.17%vs35.67%,P>0.05)和72h肌钙蛋白T下降率(65.53%vs58.96%,P>0.05)上,两组之间差异无统计学意义。结论ECMO是治疗急性暴发性心肌炎引起的心源性休克和心源性猝死的有效治疗手段,ECMO支持下的24 h肌钙蛋白T下降率在存活组高于死亡组。

Objective To analyze the effect of troponin T decrease rate on the prognosis of patients with acute fulminant myocarditis(AFM)following extracorporeal membrane oxygenation(ECMO).Methods AFM patients treated with ECMO from April 2015 to December 2018 in our hospital were enrolled in this study.According to the hospital survival,patients were divided into the survival group and non-survival group.The decrease rate of troponin T within 24,48 and 72 h were compared in the two groups.Results A total of 18 patients with a mean age of 31 years were enrolled.Fifteen patients survived and 3 patients died with an in-hospital survival rate of 83.3%.The decrease rate of troponin T within 24 h was higher in the survival group than that in the non-survival group(49.36%vs.59.57%,P<0.05),while there were no statistical differences in 48 h and 72 h between the two groups(57.17%vs.35.67%,65.53%vs.58.96%;all P>0.05).Conclusions ECMO is an effective treatment for cardiogenic shock or cardiac arrest caused by AFM.The decrease rate of troponin T within 24 h supported by ECMO is higher in the survival group.