[肠出血性大肠杆菌O157: H7感染相关窦性心动过缓的心电图研究]。

M Sanada, H Okano, S Yokota, T Kanikawa, T Itou, T Oh-ishi, K Ogawa
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引用次数: 0

摘要

1990年10月,日本埼玉县的一所幼儿园爆发了严重的出血性结肠炎。受肠出血性大肠杆菌O157: H7感染影响的儿童表现为明显的心动过缓以及严重的出血性腹泻、全身抽搐或溶血性尿毒症综合征。以往关于肠出血性大肠杆菌感染的报告中未描述在本次暴发中观察到的患者心脏受累,如心动过缓,而由于伤寒沙门氏菌感染而引起的伤寒中心动过缓是众所周知的。利用静息心电图和霍尔特24小时心电图进行心电图检查以评估心绞痛。在本报告中,我们证明了心动过缓是由于窦房结频率降低所致。夜间平均心率(74.0 +/- 5.6 BPM)和平均最低心率(57.0 +/- 5.1 BPM)与对照组(84.6 +/- 9.3 BPM和66.3 +/- 8.0 BPM)相比均显著降低(p < 0.01)。患者的CVRR(分别为0.120 +/- 0.019)明显高于对照组(分别为0.090 +/- 0.010)。这些结果表明,副交感神经系统的激活,即迷走神经的激活,可能诱发了肠出血性大肠杆菌感染患者的窦性心动过缓。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Electrocardiographic study of sinus bradycardia associated with enterohemorrhagic Escherichia coli O157: H7 infection].

A severe outbreak of hemorrhagic colitis occurred at a kindergarten in Saitama, Japan in October, 1990. Children who were affected by enterohemorrhagic E. coli O157: H7 infection showed apparent bradycardia as well as severe bloody diarrhea, generalized convulsion, or hemolytic uremic syndrome. Cardiac involvement such as bradycardia observed in the patients of this outbreak has not been described in previous reports about EHEC infection, while bradycardia has been well known in typhoid fever due to salmonella typhosa infection. Electrocardiographic examination was performed to evaluate bardicardia, utilizing electrocardiography at rest and Holter's twenty-four hour electrocardiography. In the report, we demonstrate that the bradicardia was due to reduced frequency of sinus node. Both average heart rate and average minimum heart rate of the patients at night (74.0 +/- 5.6 BPM and 57.0 +/- 5.1 BPM, respectively) decreased significantly, as compared with controls (84.6 +/- 9.3 BPM and 66.3 +/- 8.0 BPM respectively) (p < 0.01). CVRR of the patients (0.120 +/- 0.019, respectively) increased significantly as compared with controls (0.090 +/- 0.010, respectively). These results indicate that an activated parasympathetic nervous system, that is, activation of the vagal nerve, might have induced the sinus bradycardia observed in the patients with EHEC infection.

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