Mel'nik G V, Degtiar' L D, Andreev R E
Ter Arkh. 1999;71(11):32-4.
To study mechanisms of cardiovascular damage in leprospirosis convalescents.
Cardiovascular system was investigated in 121 leptospirosis convalescents at the age 17-58 years clinically, electrocardiographically and measuring troponin-T in blood serum.
6-12 months after leptospirosis 42.1% of patients who had leptospiral jaundice (88.4%) and bovine leptospirosis (21.6%) myocardial damages were revealed. In spite of disappearance of cardiac pain ECG readings did not return to normal. The myocardial damage has developed in the advanced stage of leptospirosis due to rhandomyolis: high concentration of myoglobin and troponin-T in the blood serum confirms this suggestion.
Clinical ECG readings as well as the level of troponin-T in the blood serum may be considered as the index of rehabilitation level in leptospirosis convalescents. It should be taken into consideration that 19.8% of the convalescents develop hypertension of renal genesis. This should be accounted for when planning prophylaxis and rehabilitation programs for young patients living in the North Caucasus--natural source of leptospirosis.
研究钩端螺旋体病康复者心血管损伤的机制。
对121名年龄在17 - 58岁的钩端螺旋体病康复者的心血管系统进行临床、心电图检查,并检测血清肌钙蛋白-T。
钩端螺旋体病发病6 - 12个月后,42.1%的钩端螺旋体黄疸型患者(88.4%)和牛型钩端螺旋体病患者(21.6%)出现心肌损伤。尽管心前区疼痛消失,但心电图读数未恢复正常。钩端螺旋体病晚期因横纹肌溶解导致心肌损伤:血清中高浓度的肌红蛋白和肌钙蛋白-T证实了这一推测。
临床心电图读数以及血清肌钙蛋白-T水平可被视为钩端螺旋体病康复者康复水平的指标。应考虑到19.8%的康复者会发生肾源性高血压。在为居住在北高加索地区(钩端螺旋体病的自然疫源地)的年轻患者制定预防和康复计划时,应考虑到这一点。