相关实验视频
怀疑心肌炎的患者的预测结果
Ingrid Kindermann1, Michael Kindermann, Reinhard Kandolf
1Universitätsklinikum des Saarlandes, Klinik für Innere Medizin III, Homburg/Saar, Germany. i.kindermann@med-in.uni-saarland.de
Circulation
|July 23, 2008
概括
疑似心肌炎的预后指标包括先进的纽约心脏协会课程和活检上的炎症. β抑制剂治疗与更好的结果有关,而病毒检测和达拉斯标准不是可靠的预测指标.
科学领域:
- 心脏病学 心脏病学
- 病理学 病理学 病理学
- 传染性疾病 传染性疾病
背景情况:
- 心肌炎是一种心肌的炎症.
- 内心肌活检是疑似心肌炎的诊断工具.
- 确定预后指标对于患者管理至关重要.
研究的目的:
- 为了确定疑似心肌炎的患者的预后指标.
- 为了将活检结果与患者的结果相关联.
- 评估不同诊断方法的预测价值.
主要方法:
- 对181名疑似病毒性心肌炎患者 (1994-2007) 的回顾性分析.
- 使用达拉斯标准 (组织学) 和免疫组织学对炎症进行内心肌瘤活检的评估.
- 通过聚合酶链反应 (PCR) 检测心脏型病毒基因组.
- 随访心脏死亡或心脏移植 (主要终点).
主要成果:
- 38%的患者具有积极的达拉斯标准;50%显示免疫组织炎症.
- 在44%的患者中检测到病毒基因组.
- 不良结果 (心脏病死亡/移植) 的独立预测因素是纽约心脏协会III/IV类,免疫组织炎症和缺乏β-阻断剂治疗.
- 达拉斯标准和病毒检测并不是结果的重要预测因素.
结论:
- 纽约心脏协会高级功能类和免疫组织学炎症预测疑似心肌炎的不良结果.
- 贝塔抑制剂治疗与不良事件的风险降低有关.
- 组织学发现 (达拉斯标准) 和病毒基因组检测不能可靠地预测这个患者队列的预后.
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