不同临床分型新型冠状病毒肺炎患者的心脏表现特征

Analysis on the cardiac features of patients with different clinical types of novel coronavirus disease 2019

目的探讨不同临床分型新型冠状病毒肺炎患者的心脏表现特征。方法采用回顾性研究方法收集66例新型冠状病毒肺炎确诊患者的一般临床资料、血清心肌损伤生化标志物及炎症指标峰值阳性数占比,结合4种临床分型分析;再将重型、危重型患者归为危重症组,以轻型、普通型患者作为对照组进一步比较每种指标阳性率间的差异。结果 4种临床分型的患者年龄中位数间差异有统计学意义(P<0.05),性别、高血压、糖尿病占比及入院时首次静息状态下的异常心率占比间比较差异无统计学意义(P>0.05);4组肌酸激酶(CK)、肌酸激酶-MB工酶(CK-MB)异常率间的差异无统计学意义(P>0.05),天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌钙蛋白I(cTnI)、肌红激酶(MYO)及C反应蛋白(CRP)异常率间差异均有统计学意义(P<0.05)。进一步分为危重症组和对照组后,危重症组年龄中位数大于对照组(P<0.05),危重症组的CK值异常率与对照组差异无统计学意义(P>0.05),AST、LDH、cTnI、MYO、CK-MB及CRP值异常率均高于对照组,差异有统计学意义(P<0.05)。结论高龄患者可能对新型冠状病毒更为易感,更易恶化。不同临床类型的新型冠状病毒肺炎患者心肌损伤程度与临床分型基本一致,其中重型及危重型患者损伤的发生率更大。

Objective To investigate and analyze the clinical cardiac characteristics of patients with different clinical types of novel coronavirus disease 2019(COVID-19).Methods Clinical data of 66 patients with COVID-19 were retrospectively analyzed, including serum biochemical markers of myocardial injury and inflammatory biomarkers.Results There were statistically significant differences among four clinical types by a in median age and abnormal rates of AST, LDH, cTnI, MYO and CRP among 4 clinical types of COVID-19 patients(P<0.05). There was no statistically significant difference in the gender, hypertension, diabetes or abnormal first resting heart rate among them(P>0.05). The critically ill patients in critical group were significantly older than mild patients(P<0.05), and had more prominent laboratory abnormalities, including AST, LDH, cTnI, MYO, CK-MB and CRP(P<0.05).Conclusion Elderly patients may be more susceptible to COVID-19. The degree of myocardial injury in affected patients of different clinical types is basically consistent with the clinical classification, and severe patients are more likely to get myocardial injury.