中国实用内科杂志

中国实用内科杂志 ›› 2013, Vol. 33 ›› Issue (1): 9-12.

• 专题笔谈 • 上一篇    下一篇

Brugada综合征危险分层和诊治

杨新春，石亮   

  1. 首都医科大学附属北京朝阳医院心脏中心，北京 100020
  • 出版日期:2013-01-01 发布日期:2013-01-05
  • 作者简介:杨新春，主任医师、教授、博士生导师。首都医科大学附属北京朝阳医院心脏中心主任、首都医科大学心血管疾病研究所所长。兼任中华医学会内科学分会常务委员、中华医学会心电生理和起搏分会委员会常务委员等。主持承担多项国家及省部级课题，获国家科技进步奖等多项学术奖项。1999年获塞克勒中国医师年度奖。

Risk grading，diagnosis and treatment of Brugada syndrome

YANG Xin-chun，SHI Liang
  

  1. The Heart Center of Beijing Chaoyang Hospital Affiliated to the Capital Medical University,Beijing 100020，China
  • Online:2013-01-01 Published:2013-01-05

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摘要：

摘要：Brugada综合征(BS)是一种心脏结构正常的遗传性心脏离子通道病，多是由于右心室心肌Na通道失活加速和瞬时外向钾电流(Ito)增强造成电压梯度，该梯度通过2相折返机制导致室性心动过速或心室颤动，其心电图(ECG)表现是右侧胸导联(V1～V3)的ST段呈穹窿型抬高。对于BS的诊断需结合心电图特征和临床表现，同时除外其他原因引起BS样心电图改变后方可确诊。男性、自发异常ECG、既往有晕厥史等都被认为是BS患者发生心脏猝死的高危预测因子，然而对于电生理检查(EPS)在BS危险分层，特别是猝死风险评估中的作用仍存在巨大争议。本文将就Brugada综合征的危险分层、诊断及治疗的最新进展进行综述。
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Abstract:

Abstract：Brugada syndrome (BS) is an inherited heart disease without structural abnormality that arises mostly from an accelerated inactivation of Na+ channels and potentiation of transient outward K+ current (Ito) that generates a voltage gradient.This triggers a phase 2 reentrant mechanism leading to ventricular tachycardia or fibrillation that is featured by a coved STsegment elevation in the right precordial leads (V1～V3) during electrocardiography (ECG).The diagnosis of BS is established based on the ECG pattern and clinical symptoms and by excluding the confounding factors that could account for the ECG abnormality.Although the risk factors of sudden cardiac death consist mainly of being male，presence of spontaneous ECG abnormality and a history of syncope，the role of electrophysiologic assay remains controversial in terms of risk grading，particularly in prediction of sudden death.In this review，we delineated the latest progress in the risk grading，diagnosis and treatment of Brugada syndrome.

Key words: electrocardiogram, risk stratification, Brugada syndrome

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