发热诱发Brugada波的遗传学及心电参数危险因素分析  

Clinical and genetic characteristics of fever-induced brugada type electrocardiogram in Chinese

作　　者：胡金柱[1] 洪葵[1,2,3] 俞建华[1,2,3] 周慧[1] 刘勇[4] 陈静[1,2] 李菊香[1,2,3] 颜素娟[1] 程晓曙[1,2,3] 

机构地区：[1]南昌大学第二附属医院心内科,江西南昌330006 [2]南昌大学心血管病研究所 [3]江西省医学遗传和基因治疗研究所 [4]南昌大学公共卫生学院

出　　处：《中国心脏起搏与心电生理杂志》2009年第3期209-211,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金项目(项目编号:30760076);江西省省科技支撑重点项目(编号2007BS02346);国家重点基础研究发展计划973(编号2007CB512002)

摘　　要：目的对发热诱发Brugada波的遗传学及心电参数危险性进行分析。方法使用DNA直接测序法对临床收集的5例发热诱发Bmgada波患者进行基因筛查，并回顾性调查127例住院发热患者心电图上Brugada波和不完全右束支传导阻滞（IRBBB），并与正常对照组进行心电参数的比较。结果5例发热诱发BrugadaECG患者未发现基因突变。127例发热患者Brugada波1例，发生率为0．8％，13例有IRBBB。发热组患者QTc和TpTe间期较正常对照延长（P〈0．05）。0．5～3年随访126例患者无一例发生心源性猝死。结论发热致Brugada波个体与钠通道基因突变无关联。发热诱发Brugada波的健康个体心血管事件发生率低。Objective To study genetic and clinical features of fever-induced Brugada type electrocardiogram（ECG） in Chinese. Methods 5 cases with fever-induced Brugada ECG were collected. We also retrospectively assessed the.prevalence of Brugada type ECG and incompletely right bundle-branch block （IRBBB） in 127 consecutive index Chinese patients with fever on admission from 200342006. The candidate genes encoding sodium channel or modifying sodium channel, including SCNSA, SCNlb and GPD1L were screened by direct sequencing to see if the fever-induced Brugada type ECG in patients is related to genetics and declare the clinical significance of an incidental finding of a Brugada-type ECG pattern. Results One of 127 （0.8%） patients showed Brugada type ECG and 13 of 127（ 10.2% ） showed IRBBB. The QRS and QTc were prolonger in fever group than that in no-fever group. Mutation was not found in those 5 patients with fever-induced Brugada type ECG in SCNSa, SCN1 b and GPD1-L genes. None of patients died of sudden cardiac death during follow-up. Conclusion Fever-induced Brugada type ECGs in normal individuals were thought to be at very low risk for sudden cardiac death. The Chinese subjects with fever-induced Brugada type ECG might not be related to sodium channel mutation.

关 键 词：心血管病学 BRUGADA综合征 发热 钠通道 心电图 遗传 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]