乳酸脱氢酶指示从暴发性心肌炎发展到慢性持续性心肌炎:一项中国多中心回顾性队列研究

IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
International Journal of General Medicine Pub Date : 2025-03-06 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S509291
Qu Zhao, Zeping Li, Dao Wen Wang, Fan Li, Li Zhang, Jiangang Jiang
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引用次数: 0

摘要

背景:暴发性心肌炎(FM)是心肌炎的重要表现。然而,临床特征和与不良后果相关的危险因素尚不完全清楚。鉴于FM的高死亡率和潜在的长期并发症,确定可以预测其发展为慢性持续性心肌炎的因素至关重要。我们假设一些临床或实验室标记物可以预测这种进展。本研究旨在确定可能有助于预测FM发展为慢性持续性心肌炎的临床因素。方法:采用中国方案治疗的FM患者82例。采用Kaplan-Meier曲线和回归分析确定慢性持续性心肌炎患者随访24个月的临床特征和预后预测因素。结果:20例患者在随访中出现慢性持续性心肌炎。ROC曲线显示乳酸脱氢酶(LDH)诱发慢性持续性心肌炎的临界值为577.00U/L(敏感性75.0%,特异性74.2%)。单因素和多因素cox分析均确定FM患者慢性持续性心肌炎的危险因素为发病至入院时间大于6天、LDH bb0 577.00U/L。风险比和95%置信区间分别为3.35 (1.32 ~ 8.50)(p = 0.011)和6.11 (2.02 ~ 18.48)(p < 0.001)。LDH增加的每标准差与慢性持续性心肌炎发生的HR和95% CI相关,分别为55%(1.55,1.11-2.18)。结论:按照中国心脏病学会共识的生命支持措施治疗的FM患者中,约24.4%出现慢性持续性心肌炎。从发病到入院时间超过6天,入院时LDH水平bb0 577.00 U/L可能是FM发展为慢性持续性心肌炎的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lactate Dehydrogenase Indicates Development From Fulminant Myocarditis to Chronic Persistent Myocarditis: A Multicenter Retrospective Cohort Study in China.

Background: Fulminant myocarditis (FM) is a critical manifestation of myocarditis. However, the clinical features and risk factors associated with its adverse outcomes are not fully understood. Given the high mortality and potential for long-term complications, it is crucial to identify factors that could predict the progression of FM to chronic persistent myocarditis. We hypothesize some clinical or laboratory markers may be predictive of this progression. This study aims to identify clinical factors that may help predict the progress of FM to chronic persistent myocarditis.

Methods: A total of 82 patients with FM treated based on Chinese protocol were included. Kaplan-Meier curve and regression analysis were used to determine the clinical features and prognostic predictors of chronic persistent myocarditis in patients with 24 months of follow-up.

Results: Chronic persistent myocarditis was observed in 20 patients during the follow-up. ROC curve showed that the critical value for chronic persistent myocarditis caused by lactate dehydrogenase (LDH) was 577.00U/L (sensitivity 75.0%, specificity 74.2%). Time from onset to admission over 6 days and LDH > 577.00U/L were identified as risk factors for chronic persistent myocarditis in patients with FM in both univariate and multivariate cox analysis. The hazard ratio and 95% Confidence intervals were 3.35 (1.32-8.50) (p = 0.011) and 6.11 (2.02-18.48) (p < 0.001), respectively. The per standard deviation of increment in LDH was associated with the 55% (1.55, 1.11-2.18) in HR and 95% CI of the occurrence of chronic persistent myocarditis.

Conclusion: About 24.4% of the patients with FM treated based on the life support measures proposed in the consensus of Chinese Society of Cardiology have been observed chronic persistent myocarditis. Time from onset to admission over 6 days and LDH levels >577.00 U/L at admission may serve as risk factors for the progression from FM to chronic persistent myocarditis.

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来源期刊
International Journal of General Medicine
International Journal of General Medicine Medicine-General Medicine
自引率
0.00%
发文量
1113
审稿时长
16 weeks
期刊介绍: The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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