早复极和早复极综合征与心脏性猝死  

Early Repolarization and Early Repolarization Syndrome-Associated Sudden Cardiac Death

作　　者：杨威[1] 吴林[1] 

机构地区：[1]北京大学第一医院心内科,北京100034

出　　处：《心血管病学进展》2014年第6期642-644,共3页Advances in Cardiovascular Diseases

基　　金：国家自然科学基金(2011130003)

摘　　要：早复极是临床常见的心电图表现,当具有早复极心电图表现的患者出现恶性心律失常甚至猝死时称为早复极综合征。早复极综合征患者10%可以检测到基因学改变,发生猝死的危险性与ST段抬高部位波及下壁和侧壁、抬高幅度≥0.2 m V,具有心律失常或猝死家族史等相关。诊断需除外器质性心脏病和Brugada综合征等,临床应注意心电图早复极与早复极综合征的区别和危险分层。对有心脏骤停史者应植入植入式心脏复律除颤器,异丙肾上腺素可用于早复极综合征合并的电风暴,奎尼丁对植入式心脏复律除颤器植入后患者可能预防复发。Early repolarization is a common electrocardiogram phenomenon in clinic. When cardiac arrest occurred in a patient with early repolarization changes, early repolarization syndrome is diagnosed. Genetic abnormalities is found in 10% patients with early repolar- ization syndrome. The risk of sudden cardiac death is high in patients with ST elevation in both inferior and lateral chest leads, amplitude of ST elevation is ~〉0. 2 mV and a history of cardiac arrest in the patients or patient＇ s family. It should be differentiated with structural heart diseases and Brugada syndrome. Implanted cardiac defibrillator should be implanted in patients with history of cardiac arrest. Isopreterenol is effective in treating electrical storm and quinidine may be used to prevent the recurrence of cardiac arrest after implanted cardiac defibrillator implantation.

关 键 词：早复极 早复极综合征 心脏骤停 猝死 植入式心脏复律除颤器 

分 类 号：R541.78[医药卫生—心血管疾病]