Ni Ziying, Guo Zhidong, Chen Xi, Wang Qiqi, Qiu Yuangang, Wu Tao, Yang Yida, Zhao Lili
Department of Emergency, First People's Hospital of Hangzhou, Zhejiang Province, People's Republic of China.
Acta Cardiol. 2011 Aug;66(4):427-32. doi: 10.1080/ac.66.4.2126589.
In March 2009, the novel 2009 influenza A (H1N1) was first reported in the southwest of Mexico, and rapidly spread worldwide. We investigated the clinical features of cardiovascular involvement of patients infected with the 2009 influenza A (H1N1) virus in China.
This retrospective study recruited one hundred and seventy-two patients with 2009 influenza A (H1N1) of different severity (non-severe, severe, critically severe) and 21 patients who were influenza A (H1N1)-negative but who had an influenza-like illness. Blood was obtained for measurement of the concentration of creatine kinase (CK), creatine kinase-MB (CK-MB) and high sensitivity C-reactive protein (hs-CRP) in plasma. Chest radiography was also undertaken to calculate the cardiothoracic ratio (CTR).
influenza A (H1N1) caused more illness in middle-aged people. The patients in the non-severe group were younger than in the severe group (P < 0.05) and the non-influenza A (H1N1) group (P < 0.01). The level of CK, CK-MB, hs-CRP and the CTR was higher in the critically severe group than in the other three groups (P < 0.001, P < 0.05, P < 0.01, P < 0.01, respectively).
Myocardial injury was quite serious in severe infection by the influenza A (H1N1) virus, particularly in critically severe patients. Patients with 2009 influenza A (H1N1) had injury and dilation of the heart, which may be a potential cause of death.
2009年3月，新型甲型H1N1流感首先在墨西哥西南部被报道，并迅速在全球传播。我们对中国感染2009甲型H1N1流感病毒患者心血管受累的临床特征进行了调查。
这项回顾性研究纳入了172例不同严重程度（非重症、重症、危重症）的2009甲型H1N1流感患者以及21例甲型H1N1流感阴性但患有流感样疾病的患者。采集血液以测定血浆中肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）和高敏C反应蛋白（hs-CRP）的浓度。还进行了胸部X线摄影以计算心胸比（CTR）。
甲型H1N1流感在中年人中导致更多疾病。非重症组患者比重症组患者年轻（P<0.05），且比非甲型H1N1流感组患者年轻（P<0.01）。危重症组的CK、CK-MB、hs-CRP水平和CTR均高于其他三组（分别为P<0.001、P<0.05、P<0.01、P<0.01）。
甲型H1N1流感病毒严重感染时心肌损伤相当严重，尤其是在危重症患者中。2009甲型H1N1流感患者存在心脏损伤和扩张，这可能是潜在的死亡原因。
