【摘要】 目的：探讨暴发性心肌炎(FM)患者的临床特征，并分析其前驱症状及病程进展的特点。方法：纳入301例FM患者，收集患者的一般资料、前驱症状及病程进展情况，并对数据进行统计分析。结果：FM患者前驱症状以胸闷最为常见，其次为发热、乏力、气促或呼吸困难、胸痛等。患者根据前驱症状可归纳为卡他症状型、胃肠症状型、休克型、急性心力衰竭型、心绞痛型和恶性心律失常型。该病进展极快，有1/10的患者在24 h(1 d)内以及超过1/3的患者在1～3 d内进展为FM。结论：FM患者的前驱症状以胸闷、发热及卡他症状为主，半数患者在就诊时即表现为休克型和急性心力衰竭型。其病程进展迅速，部分患者可在首次出现不适症状的24 h内恶化。出现类似症状的患者应高度警惕FM,及时进行心肌损伤标志物检测和心脏影像学检查，以实现早期识别与诊断。更多还原

【Abstract】 Objective: To investigate the clinical characteristics of hospitalised patients with fulminant myocarditis(FM) and to analyse the features of its prodromal symptoms and disease progression. Method: A total of 301 patients with FM were included. General patient details, prodromal symptoms, and disease progression were collected, with statistical analysis performed on the data. Results: Chest tightness was the most common prodromal symptom in FM patients, followed by fever, fatigue, shortness of breath or dyspnoea, and chest pain. Patients could be categorised according to their prodromal symptoms into catarrhal, gastrointestinal, shock, acute heart failure, angina pectoris, and malignant arrhythmia types. The disease progressed extremely rapidly, with 1/10 patients developing FM within 24 h(1 day) and over 1/3 of patients developing FM within 1 to 3 days. Conclusion: The prodromal symptoms of FM patients in our hospital have primarily included chest tightness, fever, and catarrhal symptoms. Half of the patients presented with shock or acute heart failure upon initial consultation. The disease progression is rapid, with some patients deteriorating within 24 h of the onset of initial discomfort. Patients presenting with such symptoms should be highly vigilant for FM. Prompt assessment with cardiac injury marker testing and cardiac imaging is essential for early recognition and diagnosis.更多还原