腺垂体功能减退症伴长QT综合征发作尖端扭转性室速一例

Anterior pituitary hypofunction with long QT syndrome episodes of torsades de pointes ventricular tachycardia:report of one case

患者男性 63 岁,因突发晕厥急诊入院,发病时在外院颅脑 MRI 示 :空泡蝶鞍,ECG 示 :长 QT 伴尖端扭转型室速,给与胺碘酮静脉用药后终止室速,后转入笔者医院,期间无明显诱发因素再发两次。辅助检查 :动态心电图示 :QT570-640ms 窦性心动过缓,交界区逸搏心律 ;腺垂体功能低下。有植入 ICD 的绝对适应征,因患者个人因素给予植入 DDD 起搏器,并合用心得安调节心室率在 60-70 次 /min,随访半年无再发。该个案临床过程表现为空泡蝶鞍综合征 ESS 并垂体功能低减后出现 TDP,无其它引发因素,类似报道罕见,我们认为二者可能相关,具体是否存在关联或者因果关系尚需进一步医学证明。

Patients with men 63 years of age,due to a sudden syncope emergency admissions,morbidity when in the outer court head MRI shows:empty sella,ECG shows:long QT with torsade de pointes ventricular tachycardia after intravenous administration of amiodarone,give terminating ventricular tachycardia,then transferred to the hospital,with no obvious predisposing factors during hair two times.Auxiliary examination:dynamic electrocardiogram shows:QT570-640ms sinus bradycardia in heartbeat,junctional escape rhythm;hypopituitarism.Implanted ICD absolutely suitable for patients,because of personal factors give DDD pacemaker implantation,and combined with propranolol regulation of ventricular rate in 60-70 /min,follow-up for half a year without recurrence.The clinical course is empty sella syndrome ESS and pituitary function reduction after TDP,without other trigger factors,similar to those reported in rare,we suggested that the two may be related,specifically whether there is any association or causation need further medical certificates.