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儿科患者的心脏离子通道病——7年单中心经验

Cardiac channelopathies in pediatric patients - 7-years single center experience.

作者信息

Illikova V, Hlivak P, Hatala R

机构信息

Departments of Arrhythmias and Pacing and ICU, Children's Cardiac Center, Comenius University School of Medicine and National Cardiovascular Institute, Slovak Medical University School of Medicine, Bratislava, Slovakia.

Departments of Arrhythmias and Pacing and ICU, Children's Cardiac Center, Comenius University School of Medicine and National Cardiovascular Institute, Slovak Medical University School of Medicine, Bratislava, Slovakia.

出版信息

J Electrocardiol. 2015 Mar-Apr;48(2):150-6. doi: 10.1016/j.jelectrocard.2014.11.010. Epub 2014 Dec 6.

Abstract

INTRODUCTION

Channelopathies are associated with mutations of genes encoding proteins creating or interacting with the specialized ion channels in myocardial cell membranes, thus forming arrhythmogenic substrate predisposing the patient to sudden cardiac death. The study focuses the clinical and ECG presentation and management of children with channelopathies in Slovakia.

SUBJECT AND METHODS

Twenty-two children with suspected channelopathy were admitted to Children's Cardiac Center Bratislava in the years 2007-2014. Genetic testing was made in 19 patients.

RESULTS

Fourteen patients were symptomatic. Long QT syndrome was genetically proven in eight and catecholaminergic polymorphic ventricular tachycardia in five patients. Twenty children are treated with beta-blockers, five in combination with mexiletine or flecainide. Nine patients received implantable cardiac defibrillator and one underwent left cardiac sympathetic denervation.

CONCLUSION

Both clinical presentation and genetic testing must be considered in the diagnostic and therapeutic process of channelopathies. Early diagnosis allows for adequate treatment and lifestyle modification.

摘要

引言

通道病与编码在心肌细胞膜中形成或与特殊离子通道相互作用的蛋白质的基因突变有关,从而形成致心律失常基质,使患者易发生心源性猝死。本研究聚焦于斯洛伐克通道病患儿的临床、心电图表现及治疗。

研究对象与方法

2007年至2014年间,22例疑似通道病的患儿被收治于布拉迪斯拉发儿童心脏中心。对19例患者进行了基因检测。

结果

14例患者有症状。基因检测证实8例为长QT综合征,5例为儿茶酚胺能多形性室性心动过速。20例患儿接受β受体阻滞剂治疗,5例联合美西律或氟卡尼治疗。9例患者接受了植入式心脏除颤器,1例接受了左心交感神经去神经术。

结论

在通道病的诊断和治疗过程中,必须同时考虑临床表现和基因检测。早期诊断有助于进行适当的治疗和生活方式调整。

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