[1]郑雨桐,闫美田,王 兰,等.新型冠状病毒肺炎患者并发心肌损伤的实验室及临床相关研究[J].现代检验医学杂志,2021,36(01):85-91.[doi:10.3969/j.issn.1671-7414.2021.01.022]
 ZHENG Yu-tong,YAN Mei-tian,WANG Lan,et al.Laboratory and Clinical Study on COVID-19 Patients with Myocardial Injury[J].Journal of Modern Laboratory Medicine,2021,36(01):85-91.[doi:10.3969/j.issn.1671-7414.2021.01.022]
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新型冠状病毒肺炎患者并发心肌损伤的实验室及临床相关研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年01期
页码:
85-91
栏目:
新型冠状病毒肺炎检验专题
出版日期:
2021-02-05

文章信息/Info

Title:
Laboratory and Clinical Study on COVID-19 Patients with Myocardial Injury
文章编号:
1671-7414(2021)01-085-07
作者:
郑雨桐闫美田王 兰
(1.大连医科大学,辽宁大连 116044;2.北部战区总医院检验科,沈阳 110016)
Author(s):
ZHENG Yu-tong, YAN Mei-tian, WANG Lan, et al
(1.Dalian Medical University,Liaoning Dalian 116044,China;2.Department of Laboratory Medicine, General Hospital of Northern Theater Command,Shenyang 110016,China)
关键词:
新型冠状病毒肺炎心肌损伤超敏肌钙蛋白 T肌红蛋白肌酸激酶同工酶 MB独立危险因素
分类号:
R373.19;R446
DOI:
10.3969/j.issn.1671-7414.2021.01.022
文献标志码:
A
摘要:
目的 回顾性分析新型冠状病毒肺炎( COVID-19)并发心肌损伤的临床特点及独立危险性因素,探讨病毒直接损伤心肌组织的可能性。方法 选取 2020年 2月 13日~ 3月 30日收治于泰康同济(武汉)医院确诊为 COVID-19的患者 381例。通过超敏肌钙蛋白 T水平将其分为心肌损伤组及非心肌损伤组,并对比两组患者的临床统计资料及实验室数据,分析并发心肌损伤的危险因素。并通过分析不同心肌损伤标志物异常情况了解病毒直接损伤心肌组织的可能。结果 与非心肌损伤组相比,心肌损伤组年龄较大,两组年龄差异有统计学意义( t=10.522,P=0.000),同时 ≥ 60岁年龄组的人数较多( χ2=46.559,P=0.000)。临床分型方面,心肌损伤组主要以重型患者居多,非心肌损伤组以普通型患者居多,组内占比分别为 53.38%和 72.98%。各种实验室指标的异常程度均为心肌损伤组更高,两组差异均具有统计学意义( t=-11.571~ -4.881, χ2=19.551 585~ 186.858,U=-10.729~ 16.120,均 P=0.000)。并发慢性心脏疾病、 D-二聚体 ≥ 500ng/ml以及降钙素原 ≥ 0.05ng/ml为 COVID-19患者并发心肌损伤的独立危险因素( P<0.05)。超敏肌钙蛋白 T(HSTNT)、肌红蛋白( MYO)和肌酸激酶同工酶 MB(CK-MB)三种心肌损伤标志物异常者所占比例分别为 34.91%,11.02%和 5.25%,其中危重型患者异常情况更加突出,且异常者均以并发基础疾病的患者较多。将心肌损伤标志物异常者按照入院时病程天数进行分层, HSTNT异常人数在 41~60天时达到人数高峰,而 MYO及 CK-MB异常人数整体呈下降趋势。结论 新型冠状病毒直接攻击心肌组织的可能性较小。但并发心肌损伤的 COVID-19患者以 60岁以上的老年男性为主,常并发高血压、慢性心、脑血管和肺部疾病。同时并发慢性心脏疾病、 D-二聚体以及降钙素原异常升高为 COVID-19并发心肌损伤的独立危险因素,可有效评估 COVID-19患者并发心肌损伤的可能性,对心、肺等重要脏器采取预防性保护治疗,从而有效降低死亡率。

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备注/Memo

备注/Memo:
基金项目:辽宁省自然科学基金(2019-ZD-1027);泰康同济新型冠状病毒专项基金(Tktjky2020069)。
作者简介:郑雨桐(1994-),女,在读研究生,研究方向为病原生物与分子生物学, E-mail:zhengyutong4@163.com。
通讯作者:万楠(1978-),男,博士,副主任技师, E-mail:wannan@outlook.com。
更新日期/Last Update: 2021-02-05