Mora Guillermo, Echeverry María Clara, Rey Gustavo Enrique, López Myriam Consuelo, Posada Luisa Fernanda, Rivas Fabio Aurelio
Departamento de Medicina, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, DC, Colombia.
Biomedica. 2007 Dec;27(4):483-9.
In Colombia the impact of infections of Trypanosoma cruzi are known to produce chronic cardiopathy and expressed by bradycardia. In Colombia the extent and impact of these infections has not been examined.
The current study aimed to determine the prevalence of T. cruzi infection as measured by serology, in a population of patients with cardiopathy that required a permanent pacemaker as treatment for cardiac rhythm abnormalities and conduction blocking.
A cross sectional study sampled 332 patients from the pacemaker clinic at the San Pedro Claver Hospital in Bogotá, Colombia, for one year (2004-2005). Epidemiological and clinical data were obtained through interviews and physical examination. Serological tests consisted of indirect inmunofluorescence assay and ELISA. Statistical analyses were accomplished with chi-square and Students t tests.
Of patients with pacemakers, 17.1% had anti-T. cruzi antibodies (seropositive). At the time when the pacemaker was implanted, chronic Chagas disease patients were younger (55+/-13 years) than those patients with cardiopathy (60+/-17 years) with no anti-T. cruzi antibodies (p<0.01). The seropositive group was aware of the Chagas disease vector (83.6%) in contrast to the seronegative group (39.6%, p<0.001). In 60% of the patients of the seropositive group, no clinical signs of the disease were apparent. The geographical origin of the seropositive group were traced to regions in Colombia known to be endemic for Chagas disease transmission.
Chagas disease prevalence is high in Colombian patients who required a permanent cardiac pacemaker. Chronic Chagas disease patients required pacemaker implant at a younger age in contrast with patients with other cardiac pathologies. The clinical recognition of Chagas disease associated with cardiopathy is low despite the epidemiological data.
在哥伦比亚，已知克氏锥虫感染会引发慢性心脏病，并表现为心动过缓。然而，哥伦比亚尚未对这些感染的范围和影响进行研究。
本研究旨在通过血清学检测，确定需要永久性起搏器治疗心律异常和传导阻滞的心脏病患者群体中克氏锥虫感染的患病率。
一项横断面研究对哥伦比亚波哥大圣佩德罗·克拉弗医院起搏器诊所的332名患者进行了为期一年（2004 - 2005年）的抽样调查。通过访谈和体格检查获取流行病学和临床数据。血清学检测包括间接免疫荧光测定和酶联免疫吸附测定。采用卡方检验和学生t检验进行统计分析。
在起搏器植入患者中，17.1%的患者抗克氏锥虫抗体呈阳性（血清阳性）。在植入起搏器时，慢性恰加斯病患者（55±13岁）比无抗克氏锥虫抗体的心脏病患者（60±17岁）更年轻（p<0.01）。血清阳性组对恰加斯病传播媒介的知晓率为83.6%，而血清阴性组为39.6%（p<0.001）。血清阳性组60%的患者无明显疾病临床症状。血清阳性组的地理来源可追溯到哥伦比亚已知恰加斯病传播流行的地区。
在需要永久性心脏起搏器的哥伦比亚患者中，恰加斯病患病率较高。与其他心脏疾病患者相比，慢性恰加斯病患者需要在更年轻的时候植入起搏器。尽管有流行病学数据，但与心脏病相关的恰加斯病的临床识别率较低。
