Schenone H, Contreras M C, Salinas P, Sandoval L, Pérez-Olea J, Rojas A, Solís F, Villarroel F
Departamento de Parasitología, Facultad de Medicina, Universidad de Chile, Santiago.
Bol Chil Parasitol. 1993 Jul-Dec;48(3-4):33-9.
In order to compare the frequency of electrocardiographical abnormalities among apparently healthy persons with Trypanosoma cruzi and Toxoplasma gondii infections, electrocardiogram (EKG) and the corresponding indirect hemagglutination tests (IHAT) were performed to 13,444 randomly selected rural and suburban inhabitants from the seven first regions of Chile which are located in the geographic area of distribution of Chagas' disease in the country. The IHAT for each parasitosis resulted positive (titers > or = 1:16) for Chagas' disease alone in 1,289 (9.6%), for toxoplasmosis alone in 3,519 (26.2%) and for the two infections in 994 (7.4%). EKG abnormalities of all type (AAT) and suggestive of a chagasic etiology (ASChE) were found in 18.5 and 8.3% respectively of the T. cruzi infected group, in 10.9 and 3.2% of the T. gondii infected group, in 18.9 and 4.8% of the group simultaneously infected by the two parasites, whereas AAT and ASChE were found in 7.9 and 1.8% of the IHAT negative group. All the corresponding percentage differences between abnormal EKG had a statistical significance (p < 0.05). Besides the increasing of the IHAT positivity, for each infection parallels to the age grouping of the studied persons, a similar situation was observed in the frequence of the AAT and ASChE mainly among people aged > or = 50 years. As T. cruzi and T. gondii infections sometimes isoletely adopt a high virulence and overlap in a proportion higher than 43.0% in Chagas' disease endemic areas, it is advisable to consider these etiologic possibilities in the presence of patients with a myocardiopathy of dubious interpretation, particularly when AIDS is involved.
为比较克氏锥虫和弓形虫感染的看似健康人群中心电图异常的频率,对来自智利最初七个地区的13444名随机选取的农村和郊区居民进行了心电图(EKG)检查及相应的间接血凝试验(IHAT),这些地区位于该国恰加斯病的地理分布区域。每种寄生虫病的IHAT检测结果显示,仅恰加斯病呈阳性(滴度≥1:16)的有1289人(9.6%),仅弓形虫病呈阳性的有3519人(26.2%),两种感染均呈阳性的有994人(7.4%)。在克氏锥虫感染组中,分别有18.5%和8.3%的人出现了所有类型的心电图异常(AAT)及提示恰加斯病病因的异常(ASChE);在弓形虫感染组中,这一比例分别为10.9%和3.2%;在同时感染两种寄生虫的组中,分别为18.9%和4.8%;而在IHAT检测呈阴性的组中,AAT和ASChE的比例分别为7.9%和1.8%。心电图异常之间的所有相应百分比差异均具有统计学意义(p<0.05)。除了IHAT阳性率随研究对象年龄分组增加外,AAT和ASChE的频率也呈现类似情况,主要出现在年龄≥50岁的人群中。由于在恰加斯病流行地区,克氏锥虫和弓形虫感染有时会单独表现出高毒力,且重叠比例高于43.0%,因此对于解释不明的心肌病患者,尤其是涉及艾滋病时,建议考虑这些病因可能性。