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Brugada综合征
原作者: Semhar Tewelde,陈都,肖锋 发布日期:2015-03-02
关键词:心律失常 brugada综合征 st段抬高 心电图

Title: Brugada Syndrome
题目:Brugada综合症
Author 作者: Semhar Tewelde
翻译:陈都 校对:肖锋

Brugada syndrome is an inherited arrhythmogenic channelopathy described by ST-segment elevation in the precordial leads and an increased risk of sudden cardiac death.
Brugada综合症是一种遗传性的至心律失常通道病变,表现为胸导连ST段抬高,心脏猝死风险增加。


There are 3 electrocardiographic patterns:
Type 1 – Coved morphology w/ST-elevation >2 mm, followed by a negative T wave in at least 1 precordial lead
Type 2 - Saddleback morphology w/ST-elevation >2mm, with a positive or biphasic T wave
Type 3 - Either coved, or saddleback morphology with <2mm ST-elevation
有三个心电图类型:
1型:"穹隆型"ST 段,ST段抬高超过2mm,伴随一个以上胸导连T波倒置
2型:"马鞍型"ST 段,ST段抬高超过2mm,合并一个正向或者双向T波
3型:"穹隆型"或"马鞍型",ST段抬高小于2mm

Type 1 pattern is often underestimated because of its sporadic/fluctuating appearance on ECG, which can be either spontaneously occurring or drug-induced (drug-induced variant has a more favorable prognosis).
Fever has been a well-documented culprit in unmasking Brugada pattern by increasing the sodium channel dysfunction & accelerating the late sodium current inactivation.
由于不定时或者波动出现在心电图上,1型常常被低估,其可以是自发也可以是药物诱发(药物诱发类型预后较好)。有证据表明,发热可以揭示Brugada的类型,其机制是通过增加钠通道功能障碍和加速晚期钠电流失活。

A recent study in a large population of patients with type 1 Brugada attempted to identify other patterns unmasking Brugada using 24-hour holter monitoring. * There is now evidence that there is a higher prevalence of type 1 Brugada pattern from 12 pm-6 pm & unmasking by fast and a large meal, showing influence by glucose intake and insulin levels.
最近一项基于大样本1型Brugada综合征患者的研究试图通过24小时动态心电图监测其他显示Brugada综合征的情况。现在有证据表明1型从12 pm到6 pm有更高的发病率, 出现在快速大量进食后,提示其受到葡萄糖摄入及胰岛素水平的影响。

References 参考文献:
Cerrato N, Giustetto C, et al. Prevalence of Type 1 Brugada Electrocardiographic Pattern Evaluated by Twelve-Lead Twenty-Four-Hour Holter Monitoring. The American Journal of Cardiology.Vol 115, Issue 1, 1 Jan. 2015, pgs. 52-56.