Machado E S, Feres J G, Feijó L A, Andrade J, Nogueira S A
Serviço de Doenças Infecciosas, Universidade Federal do Rio de Janiero, Brasil.
Rev Inst Med Trop Sao Paulo. 1995 Sep-Oct;37(5):461-5. doi: 10.1590/s0036-46651995000500013.
In the absence of heart failure or cardiogenic shock, cardiac involvement diagnosis in icteric leptospirosis is possible on the basis of abnormal electrocardiograms. As metabolic and electrolytic disorders are frequently seen during acute leptospirosis infection, they may be responsible for some electrocardiograms changes. We conducted a study to assess if creatine phosphokinase isoenzyme determinations are useful in selecting patients with a high cardiac involvement suspicion. Sixty-nine patients were studied prospectively. Ten patients out of 16 with cardiac involvement and 25 without had high CK-MB levels (p > 0.05), although mean values of abnormal CK-MB levels were higher in the group with cardiac involvement (p < 0.05). Our analysis indicates that serum CK-MB determination does not provide a specific indicator of myocardial involvement in the course of icteric leptospirosis.
在无心力衰竭或心源性休克的情况下，黄疸型钩端螺旋体病的心脏受累诊断可基于异常心电图做出。由于急性钩端螺旋体感染期间经常出现代谢和电解质紊乱，它们可能是某些心电图变化的原因。我们进行了一项研究，以评估肌酸磷酸激酶同工酶测定是否有助于筛选高度怀疑有心脏受累的患者。对69例患者进行了前瞻性研究。16例有心脏受累的患者中有10例，25例无心脏受累的患者中有25例肌酸激酶同工酶（CK-MB）水平升高（p>0.05），尽管有心脏受累组的CK-MB异常水平平均值更高（p<0.05）。我们的分析表明，血清CK-MB测定并不能作为黄疸型钩端螺旋体病病程中心肌受累的特异性指标。
