126例新型冠状病毒肺炎患者的心肌损伤标志物及心电图分析

Analysis of myocardial injury markers and electrocardiogram in 126 COVID-19 cases

目的分析新型冠状病毒肺炎(COVID-19)患者的心肌损伤标志物及心电图特点,探讨新型冠状病毒感染对心脏的影响.方法收集2020年1月10日至3月3日武汉大学中南医院收治的126例COVID-19患者临床资料,根据疾病严重程度将其分为轻型组、普通型组、重型组及危重型组,分析各组心肌损伤标志物及心电图的特点.结果共有126例确诊为COVID-19的患者纳入此研究,平均年龄为(57.2±15.2)岁,47.6%为男性,其中重型及危重型组年龄较轻型和普通型组大[(62.3±17.0)岁比(55.0±14.0)岁](P<0.05).重型及危重型组的患者合并更多高血压、冠心病、慢性阻塞性肺疾病等慢性基础疾病(P<0.05).与轻型及普通型患者相比,重型及危重型患者的肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)、脑钠肽(BNP)均显著增高(P<0.05).在心电图异常率分析中,重型及危重型患者比轻型和普通型组更容易出现各种心律失常(P<0.05).患者的异常心电图中出现频率较高的为ST段压低(17.5%)、T波异常(14.3%)及窦性心动过速(11.1%).不同组别的异常心电图比较,在ST段压低、窦性心动过速及心房颤动方面差异有统计学意义(P<0.05).结论COVID-19患者合并心血管基础疾病可能会加速肺炎病情的发展,重型和危重型患者更容易出现心肌损伤、心律失常及心力衰竭.

Objective To investigate the myocardial injury markers and electrocardiogram characteristics of patients with novel coronavirus pneumonia(COVID-19)and the impact of the virus on the heart.Methods The clinical data of 126 COVID-19 patients admitted to Zhongnan Hospital of Wuhan University from January 10 to March 3,2020 were reviewed.The patients were divided into mild group,common group,severe group and critical group and the characteristics of myocardial injury markers and electrocardiogram in each group were anlalysed.Results A total of 126 patients diagnosed with COVID-19 were included in this study.The average age of the patients was(57.2±15.2)years,47.6%were male and the patients in the severe and critical group were older than the light and common group[(62.3±17.0)years old vs.(55.0±14.0)years old](P<0.05).Patients in the severe and critical group combined with more chronic underlying diseases such as hypertension,coronary heart disease and chronic obstructive pulmonary disease(P<0.05).Compared with those in light and common group,cTnI.CK-MB and BNP were significantly higher in severe and critical group(P<0.05).In the analysis of abnormal rate of electrocardiogram,patients in the severe and critical group are more prone to various arrhythmias than light and common group(P<0.05).The more frequent abnormal electrocardiograms were ST segment depression(17.5%),T wave abnormalities(14.3%)and sinus tachycardia(11.1%).Comparison of abnormal electrocardiograms in different groups showed statistically significant differences in ST-segment depression,sinus tachycardia and atrial fibrillation(P<0.05).Conclusion COVID-19 patients with cardiovascular disease may accelerate the development of pneumonia;severe and critically patients are more prone to myocardial damage,arrhythmias and heart failure.