发热诱发Brugada综合征的临床及心电图特征

Clinical and Electrocardiogram Characteristics of Fever-induced Brugada Syndrome

目的探究发热诱发Brugada综合征的临床及心电图特点。方法选择2000年1月—2019年1月武汉大学人民医院收治Brugada综合征患者112例,根据诱发因素将全部病例分为发热组(34例)和非发热组(78例),比较分析两组临床特点及药物激发试验结果。结果发热组在主要不良心血管事件发生率及家族史比例方面均显著大于非发热组(52.94%vs 29.49%,P=0.018;17.65%vs 3.85%,P=0.036);药物激发试验阳性的发热组患者表现出较发热时更长的QT间期和PR间期[(371.00±43.06)ms vs(327.00±36.89)ms,P=0.015;(187.88±27.41)ms vs(156.75±9.56)ms,P=0.022]。结论发热诱发Brugada综合征存在着相对较高的主要不良心血管事件风险和相关家族史比例,同一患者由发热与药物诱导的Brugada心电图也存在差异,表明发热诱发Brugada综合征具备相对独特的临床和心电图特点。

Objective To explore the clinical and electrocardiogram characteristics of fever-induced Brugada syndrome.Methods From January 2000 to January 2019,112 patients with Brugada syndrome who were treated in Renmin Hospital of Wuhan University,were divided into fever group(34 cases)and non-fever group(78 cases)according to predisposing factors.The clinical characteristics and drug challenge test results were analyzed.Results The ratio of major adverse cardiovascular events and related positive family history in patients with fever-induced Brugada syndrome were significantly higher than those in non-febrile patients(52.94%vs 29.49%,P=0.018;17.65%vs 3.85%,P=0.036).Patients in fever group who tested positive in drug challenge test,showed prolonged QT interval and PR interval than that during fever[(371.00±43.06)ms vs(327.00±36.89)ms,P=0.015;(187.88±27.41)ms vs(156.75±9.56)ms,P=0.022].Conclusion Fever-induced Brugada syndrome has relatively high incidence of major adverse cardiovascular events,and a relatively large proportion of positive family history.There were differences in febrile and drug-induced Brugada electrocardiogram in the same patients.This study shows that fever-induced Brugada syndrome has relatively unique clinical and electrocardiogram characteristics.