儿童阿狄森氏病合并尖端扭转型室性心动过速1例  

Case report of children with Addison′s disease complicated by torsades de pointes

作　　者：王娟莉[1] 李健[1] 肖红玉 李环[1] 雷茜[1] 王涛[1] Wang Juanli;Li Jian;Xiao Hongyu;Li Huan;Lei Xi;Wang Tao(Department of Cardiovascular,Children′s Hospital Affiliated to Xi′an Jiaotong University,Xi′an 710003,China)

机构地区：[1]西安交通大学附属儿童医院心血管内科,西安710003

出　　处：《中华实用儿科临床杂志》2024年第10期783-785,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：西安市卫生健康委面上培育项目(2020ms12)。

摘　　要：回顾性分析西安交通大学附属儿童医院2021年7月收治的1例阿狄森氏病合并尖端扭转型室性心动过速患儿的临床资料。患儿,女,12岁,因反复发作抽搐、晕厥、昏迷,多次在当地住院抢救治疗,先后诊断为"暴发性心肌炎""室上性心动过速"等,后转入西安交通大学附属儿童医院,住院心电监测期间发现与发作相关的尖端扭转型室性心动过速,发作间期心电图表现Q-T间期延长,最长Q-Tc 564 ms,心脏彩超检查提示左心室稍扩大,左心室收缩分数减低,后经全面检查确诊为阿狄森氏病。予氢化可的松静脉滴注3 d后口服氢化可的松片序贯治疗,晕厥等症状再未发作,Q-T间期逐渐恢复正常,继续治疗1年后,心脏彩超检查完全恢复正常。本报道旨在提高儿科医师对儿童内分泌疾病与心律失常关系的认识及研究。This article retrospectively analyzes the clinical data of a patient with Addison′s disease complicated by torsades de pointes treated in Children′s Hospital Affiliated to Xi′an Jiaotong University in July 2021.The patient,female,aged 12 years,was hospitalized multiple times due to recurrent seizures,syncope,and coma,and had been successively diagnosed with fulminant myocarditis,supraventricular tachycardia,etc.She was later transferred to Children′s Hospital Affiliated to Xi′an Jiaotong University,where during hospitalization,electrocardiogram(ECG)monitoring revealed torsades de pointes associated with the attacks.The ECG between attacks showed a prolonged Q-T interval,with the longest Q-Tc of 564 ms.Echocardiography suggested a slight enlargement of the left ventricle and reduced left ventricular ejection fraction.After a comprehensive examination,she was diagnosed with Addison′s disease.Treatment with intravenous Hydrocortisone for 3 days,followed by oral Hydrocortisone tablets,was administered sequentially.After treatment,symptoms such as syncope did not recur,and the Q-T interval gradually returned to normal.After continued treatment for 1 year,echocardiography revealed no abnormality.This report aims to enhance pediatricians′understanding and research on the relationship between pediatric endocrine diseases and arrhythmias.

关 键 词：阿狄森氏病 尖端扭转型室性心动过速 Q-T间期延长 

分 类 号：R725.4[医药卫生—儿科]