【摘要】 目的 探讨新型冠状病毒肺炎(COVID-19)患者心肌损伤及心功能不全对病情严重程度的影响及其临床意义。方法 对2020年1月至3月90例重症及危重症COVID-19患者的临床资料进行回顾性分析。结果 90例患者中,重症58例,危重症32例;男50例(55.6%),女40例(44.4%);年龄29～82岁,重症患者中位年龄(54.1±15.7)岁,危重症患者中位年龄(67.5±12.4)岁,危重症患者组平均年龄较重症组明显增加(P<0.05)。重症组中有17例(29.3%)合并基础病显著低于危重症组(20例,62.5%,P<0.05)。入院时危重症患者在心肌损伤标志物血清天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)和肌钙蛋白I (cTnI)、心功能指标N末端B型利钠肽原(NT-proBNP)、炎症反应指标超敏C-反应蛋白(hs-CRP)、凝血功能指标D-二聚体(D-D)水平危重组均较重症组明显升高,差异有统计学意义(P<0.05)。结论 入院时合并心肌损伤及心功能不全是COVID-19危重症型患者的重要临床特征。更多还原

【Abstract】 Objective To explore the influence of myocardial injury and cardiac insufficiency on the severity of COVID-19 and its clinical significance.Methods Clinical data of 75 patients with severe or critical COVID-19 in Honghu People’s Hospital from January to March in 2020 were collected.Results Of the 90 patients with COVID-19 pneumonia,50 were male(55.6%),40 were female(44.4%),58 were severe,32 were critical.The median age of severe patients was(54.1±15.7) years old,and the median age of critical ill patients was(67.5±12.4) years old.The average age of critical ill patients was significantly higher than that of severe patients(P<0.05).In the severe group,17 cases(29.3%) were complicated with underlying diseases,which were significantly lower than those in the critical ill group(20 cases,62.5%,P<0.05).On admission,the levels of serum cardiac injury index of AST,LDH,CK,CK-MB and cTnI,cardiac function index of NT-proBNP,inflammatory response index of hs-CRP and coagulation function index of D-dimer in critically ill patients were significantly higher than those in severe patients.Conclusion Myocardial injury and cardiac dysfunction at admission are important clinical features of critically ill patients with COVID-19.更多还原