患有莱姆关节炎的儿童心电图异常
Deborah L Hammett1,2, Erica Del Grippo3,2, Claire E Loiselle1
1From the Division of Emergency Medicine.
The Pediatric infectious disease journal
|August 20, 2024
概括
电心电图 (ECG) 异常在莱姆病关节炎的儿童中很罕见,并且不表明严重的心脏病. 对于无症状的儿科莱姆关节炎患者,不建议进行例行心电图查.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 莱姆氏病通常呈现分阶段,心炎在早期传播性疾病和关节炎在晚期阶段.
- 临床阶段的交叉点和儿科莱姆关节炎中心电图 (ECG) 异常的流行程度尚不清楚.
- 这项研究解决了有关莱姆关节炎诊断的儿童心电图变化的知识差距.
研究的目的:
- 确定诊断为莱姆关节炎的儿科患者心电图异常的患病率.
- 评估是否有任何临床或实验室特征与该人群中的心电图异常有关.
主要方法:
- 在第三级儿童医院对患有莱姆关节炎的儿科患者进行了回顾性,横截面研究.
- 包括通过二级血清学诊断的患者,在开始服用抗生素后2天内获得了ECG.
- 一位心脏病学家检查心脏炎指标的心电图:心房静脉阻塞,ST-T波变化,QTc延长,加速结节律,或右束支部阻塞.
主要成果:
- 在233名莱姆病关节炎患者中,有90人 (38.6%) 接受了心电图.
- 五名患者 (5.6%) 呈现出心电图异常:3人患有一级心房阻塞,1人患有QTc延长,1人患有ST-T波变化.
- 没有临床或实验室因素预测了心电图异常,所有受影响的患者都对口服抗生素有反应,没有显著的心脏后果.
结论:
- 儿科莱姆关节炎中心电图异常不常见,并不意味着临床上具有重大意义的心脏病.
- 这些发现不支持在莱姆关节炎无症状儿童中常规使用心电图查.
- 进一步的研究可能会探索这种患者群体的长期心脏影响,如果有的话.
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