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致命性心律失常和皮质激素不足。

Lethal arrhythmia and corticosteroid insufficiency.

机构信息

Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.

出版信息

Am J Emerg Med. 2009 Nov;27(9):1167.e1-3. doi: 10.1016/j.ajem.2008.12.001.

Abstract

We describe a case of isolated adrenocorticotropic hormone deficiency that showed ventricular fibrillation associated with QT prolongation. A 72-year-old man was admitted because of consciousness disorder caused by severe hypoglycemia. On the second hospital day, QT intervals were unexpectedly prolonged and ventricular fibrillation occurred. Electrical defibrillation was performed and restored hemodynamically stable condition without neurologic deficits. He was diagnosed with endocrine tests as having isolated adrenocorticotropic hormone deficiency. QT prolongation was improved after hydrocortisone replacement therapy. We considered the QT prolongation was caused by corticosteroid insufficiency. We should be aware that corticosteroid insufficiency may provoke QT prolongation responsible for sudden cardiac death.

摘要

我们描述了一例孤立性促肾上腺皮质激素缺乏症的病例,该病例表现为与 QT 间期延长相关的心室颤动。一名 72 岁男性因严重低血糖导致意识障碍而入院。住院第二天,意外出现 QT 间期延长并发生心室颤动。行电除颤后,患者血流动力学恢复稳定,无神经功能缺损。内分泌检查诊断为孤立性促肾上腺皮质激素缺乏症。氢化可的松替代治疗后,QT 间期延长得到改善。我们认为 QT 间期延长是由皮质类固醇不足引起的。我们应该意识到皮质类固醇不足可能会引起 QT 间期延长,导致心脏性猝死。

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