目的 :本文回顾分析了 3 5例确诊严重急性呼吸综合征 (SARS)患者在心血管系统方面的临床表现。方法 :3 5例确诊为SARS的患者 ,其中男性 19例 ,女性 16例 ,平均年龄 3 7 7岁 ( 15～ 82岁 ) ,临床观察项目包括体温、血氧饱和度、心率、血清酶 ,以及Χ线影像和超声心动图检查。结果 :3 5例患者中 ,有 10例 ( 2 8 6% )患者X线胸片显示心脏增大 ,以右心增大或全心增大为主 ,其中 3例呈现肺动脉段突出 ,10例中 6例为重症患者。X线胸片显示急性期 (发病 1～ 2周 )心脏影像开始增大 ,恢复期 (发病 3～ 4周 ) ,大多数患者 ( 9例 )心脏影像恢复正常。 10例患者心脏在急性期时平均心胸比率为 0 5 9± 0 0 3 ,恢复期平均心胸比率为0 5 1± 0 0 2 ,二者有显著差异 (P <0 0 5 )。所有患者心率加快并长时间呈偏高水平 ,在体温正常后 ,平均心率仍在 95次 /分以上。有 5例患者在发热期间发生过心肌酶 (肌酸激酶 ,CK)增高 ,3～ 5天后 ,心肌酶恢复正常。所有患者在恢复期期间行超声心动图检查 ,仍有 1例显示左、右心室增大 ,其余患者心脏大小均已恢复正常。结论 :本组临床观察显示 ,SARS是以肺部为突出表现的呼吸道传染病 ,亦可累及心脏使一部分患者心脏增大。随着SARS病情好转大多数增大的心脏可恢复正常 ,其机制需进 OBJECTIVE: This paper retrospectively analyzed the clinical manifestations of cardiovascular system in 35 patients with confirmed severe acute respiratory syndrome (SARS). Methods: Totally 35 patients were diagnosed as SARS, including 19 males and 16 females, with an average age of 377 years (15-82 years). The clinical observation items included body temperature, oxygen saturation, heart rate, serum enzymes, TX line imaging and echocardiography. Results: Of the 5 5 patients, 10 cases (286%) showed enlarged heart with X-ray and right heart increased or enlarged heart, 3 cases showed prominent pulmonary artery, 10 cases In 6 cases of severe patients. X-ray showed that the heart image began to increase during the acute phase (1-2 weeks after onset) and recovered during the recovery period (3-4 weeks after onset). Most patients (9 cases) returned to normal heart images. The average cardiothoracic ratio of the 10 patients during the acute phase was 0 59 ± 0 0 3, and the average cardiothoracic ratio at the recovery phase was 0 51 ± 0 0 2 (P <0 05). All patients with accelerated heart rate and high level for a long time, normal body temperature, the average heart rate is still 95 beats / min. In 5 patients, myocardial enzyme (creatine kinase, CK) increased during fever and returned to normal after 3 to 5 days. All patients underwent echocardiography during the convalescent period. Still, 1 patient showed left ventricular and right ventricular enlargement, and the rest had normal heart size. Conclusion: The clinical observation of this group shows that SARS is an infectious respiratory disease with prominent pulmonary manifestations. It can also cause heart enlargement in some patients. As the SARS condition improves, most of the enlarged hearts return to normal, and the mechanism is needed