摘要
本文应用临床电生理检查及药物激发试验,探讨了流行性出血热(EHF)并发心动过缓的机理,27例EHF中并发心动过缓18例,占66.7%.其中5例窦房结功能经电生理及药物试验揭示明显异常,符合窦房结功能不全诊断标准.余13例电生理参数较非心动过缓组及对照组明显增高,但尚在正常范围.提示EHF并发心动过缓病例中部分系窦房结功能不全所致,推测可能与窦房结区充血、水肿、炎症、出血有关;部分病例则可能是植物神经功能失调,迷走神经张力增高所致.
In this study the mechanism of sinus bradycardia has been studied in 27 patients with epidemic hemorrhagic fever (EHF) by clinic electrophysiologic examination and the pharmacological provocation test. Of 27 patients, 18 were complicated with sinus bradycardia (66.7%). The diagnosis of sinus dysfuncation was made in five of them by abnormal electrophysiologic manifestation and the pharmacological provocation test. In the other 13 patients the electrophysiologic parameters were in the normal range though significantly higher than those in the control group and the non-bradycardia group (p<0.05).
These observations suggest that some cases of bradycardia in EHF are supposed to be caused by sinus dysfunction probably owing to congestion, inflammation, edema and hemorrhage in the sinus node region, and others ought be related to the disturbance of action of the autonomic nervous system.
关键词
流行性出血热
心动过缓
病理生理学
Hemorrhagic fever, epidemic/compl
Bradycardia/physiopathol
Sinoatrial node/physiopathol
Electrophysiology
