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[急性藜芦中毒患者的心电图研究]

[Electrocardiographic studies of patients with acute hellebore (Veratrum album) poisoning].

作者信息

Marinov A, Koev P, Mirchev N

出版信息

Vutr Boles. 1987;26(6):36-9.

PMID:3439151
Abstract

In 12 patients, 20 to 80 years of age, 6 men and 6 women, with acute hellebore (Veratrum album) intoxication the electrocardiographic changes were studied. In 10 of them a characteristic ECG pattern was found: sinus bradycardia 38-40/m, shortening of the interval PQ up to 0.12-0.08 s and QTc up to 0.36-0.32 s, slow intraventricular conduction--transitory right and incomplete left bundle-branch block, rhythm disorders--atrial and substitutional ventricular extrasystoles, nodal rhythm (I patient), disturbed ventricular repolarization--depression of ST-segment, low and (or) pointed T waves. The authors are of the opinion that the bradycardia is due to a reflexively increased vagal tonus but the other changes of the ECG are caused by the direct toxic action of the hellebore alkaloids on the myocardium. This suggestion is supported by the fact that atropine corrects the bradycardia but not the other pathological changes of the ECG. They are beneficially influenced by the fast elimination of the toxins and the application of cardiotropic means--atriphos, cocarboxylase, vitamins of the group B.

摘要

对12例年龄在20至80岁之间的患者(6名男性和6名女性)进行了急性藜芦中毒时心电图变化的研究。其中10例发现了特征性的心电图模式:窦性心动过缓,心率38 - 40次/分钟,PQ间期缩短至0.12 - 0.08秒,QTc间期缩短至0.36 - 0.32秒,室内传导缓慢——短暂性右束支和不完全性左束支传导阻滞,心律失常——房性和室性早搏、结性心律(1例患者),心室复极异常——ST段压低、低平及(或)尖峰状T波。作者认为心动过缓是由于迷走神经张力反射性增加所致,但心电图的其他变化是由藜芦生物碱对心肌的直接毒性作用引起的。这一观点得到了以下事实的支持:阿托品可纠正心动过缓,但不能纠正心电图的其他病理变化。毒素的快速清除以及应用强心剂(三磷酸腺苷、辅酶A、B族维生素)对这些变化有有益影响。

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