新型冠状病毒肺炎患者心肌损伤标志物初步探讨

Preliminary study on myocardial injury markers in patients with novel coronavirus pneumonia

目的:初步探讨不同临床分型新型冠状病毒肺炎(COVID-19)患者心肌损伤标志物特征。方法:本研究是一项回顾性单中心研究,纳入了2020年1月至2020年2月,共122例COVID-19确诊病例,其中轻型/普通型共92例,重型/危重型共30例。通过实时RT-PCR确诊病例,并收集流行病学,人口统计学,临床分析,放射学特征和实验室数据。结果:根据患者病情临床分型,将所有COVID-19患者分为两组,一组为轻型和普通型,另一组为重型/危重型患者。比较两组患者一般情况结果显示:重症/危重型COVID-19患者年龄、WBC、中性粒细胞百分比、血清淀粉样蛋白A、尿素氮、谷草转氨酶、心率、体温、呼吸次数、死亡率和肺部病变范围均高于轻型/普通型患者,而淋巴细胞数、淋巴细胞百分比和血氧饱和度则低于轻型/普通型患者(P<0.05)。比较不同病情分型COVID-19患者心肌损伤标志物水平和急性心肌受损的比例结果提示:重型/危重型患者心肌酶指标、心肌酶升高所占比例和hs-cTnI水平均高于轻型/普通型患者,急性心肌受损的比例(11.1%vs.42.3%)也明显升高(P<0.05)。结论:重症COVID-19患者发生急性心肌损伤的比例为42.3%;重症COVID-19患者心肌酶、hs-cTnI水平高于轻症患者。

Objective:To investigate the markers of myocardial injury in patients with different clinical types of novel coronavirus pneumonia.Methods:This study is a retrospective single-center study,a total of 122 new coronavirus pneumonia cases were included from January 2020 to February 2020,including 92 cases of light/normal type and 30 cases of heavy/critical type.Cases were confirmed by real-time RT-PCR and epidemiological,demographic,clinical analysis,as well as radiological characteristics and laboratory data were collected.Results:According to the clinical classification of the patients,all the patients with new coronavirus pneumonia were divided into two groups,one group was mild and normal type,the other group was severe/critical type.Compare two groups of patients in general,the result show that the severe type/critical new coronavirus pneumonia patients age,WBC,neutrophil percentage,serum amyloid A,urea nitrogen,AST,heart rate,body temperature,breathing rate,death rate and lung lesions were higher than light/normal patients,lymphocyte count,percentage of lymphocytes and blood oxygen saturation is below the light/normal patients(P<0.05).To compare different disease classification new coronavirus pneumonia in patients with myocardial injury markers level and the proportion of acute myocardial damage.Results:suggest heavy/critically ill patients with myocardial enzyme index,proportion of elevated myocardial enzymes and cTnI levels are higher than light/normal patients,the proportion of acute myocardial damage(11.1%vs.42.3%)also increased significantly(P<0.05).Conclusions:The incidence of acute myocardial injury in patients with severe new coronavirus pneumonia was 42.3%.The levels of cardiac enzymes and cTnI in patients with severe new coronavirus pneumonia were higher than those in patients with mild cases.