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患者男,54岁。因发热、头痛、腰痛5天入院。出血热免疫荧光抗体试验阳性。按流行性出血热综合治疗,病情好转。入院第5日感胸闷、头晕、乏力,脉搏46次。心电图示窦性心动过缓并不齐,给予口服阿托品治疗。入院第6日突然出现意识丧失,抽搐,约1分钟后神志恢复,抽搐停止,心电监护示窦性心动过缓、窦性停搏,心率34次。给予静脉注射阿托品,静脉点滴异丙基肾上腺素,积极治疗流行性出血热,心率稳定在70次左右。住院30天出院。 讨论:本例出现严重的窦性心动过缓及阿一斯综合征的机理,可能为病毒侵犯心脏的传导系统,
Male patient, 54 years old. Due to fever, headache, back pain 5 days admitted. Haemorrhagic fever immunofluorescent antibody test positive. According to the comprehensive treatment of epidemic hemorrhagic fever, the condition improved. On the 5th day admitted chest tightness, dizziness, fatigue, pulse 46 times. Electrocardiogram shows sinus bradycardia and missing, giving oral atropine treatment. Admission on the 6th suddenly a loss of consciousness, convulsions, about 1 minute after consciousness recovery, convulsions stopped, ECG monitoring showed sinus bradycardia, sinus arrest, heart rate 34 times. Give intravenous atropine intravenous infusion of isoproterenol, active treatment of epidemic hemorrhagic fever, heart rate stable at about 70 times. 30 days hospital discharge. Discussion: In this case, severe sinus bradyarrhythmias and Asperger’s Syndrome mechanism may be the heart of the virus invasion of the conduction system,