Author/Editor		Mravljak, Marija; Velnar, Tomaž
Title		Elektrokardiografske spremembe pri otrocih z erythema migrans
Translated title		Electrocardiographic changes in children with erythema migrans
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 45, št. 1
Publication year		2006
Volume		str. 21-34
Language		slo
Abstract		Lyme borreliosis is a worldwide tick-borne illness caused by the spirochete Borrelia burgdorferi sensu lato. The number of cases rises every year. The disease progresses with an unpredictable course and affects various organ systems. Early stage skin rash, erythema migrans, and later neurologic, cardiac, and musculoskeletal involvement are distinctive of manifest infection. The most accurate for diagnosis and the most common clinical sign of the disease is erythema migrans. During the course of the disease, the heart is also involved. The principal clinical signs are conduction disturbances, myopericarditis, and cardiomyopathies. If diagnosed early, electrocardiographic changes may influence the choice of antibiotic treatment and prognosis. Electrocardiographic changes were studied in children with erythema migrans and compared to electrocardiographic findings from a comparable healthy control group. 147 children with typical erythema migrans were included in our prospective study. The control group consisted of 148 healthy children of the same sex and comparable age. Electrocardiographs were obtained for patients and for the control group. All children were divided into age groups according to their heart rate, PR interval duration, heart axis, duration and amplitude of the QRS interval, Q wave, R/S ratio, T wave and QT interval. Statistical data were processed using the s-test, t-test (Kruskal-Wallis) and x2 test (Fischer). 5% of patients and 14% of healthy children from the control group had pathological electrocardiographs. In comparison with healthy children, the patients had shorten PR and RP interval durations and lower R and S wave voltage in V1. Among the patients, boys had patological electrocardiographs more often than girls. (Abstract truncated at 2000 characters)
Summary		Lymska borelioza je zoonoza, ki jo prenašajo klopi. Povzroča jo bakterija Borrelia burgdorferi sensu lato. Število bolnikov iz leta v leto narašča. Bolezen ima nepredvidljiv potek in prizadene številne organske sisteme. Za manifestno okužbo je v zgodnjem obdobju značilen kožni izpuščaj, erythema migrans, kasneje pa prizadetost živčevja, srca in sklepov. Edini zanesljivi in najpogostejši klinični znak za diagnozo lymske borelioze je erythema migrans. V poteku lymske borelioze je lahko prizadeto tudi srce. Znaki lymskega karditisa so motnje prevajanja, mioperikarditis in kardiomiopatija. Zgodaj ugotovljene elektrokardiografske spremembe bi lahko vplivale na izbiro začetnega antibiotičnega zdravljenja in napoved bolezni. Ugotavljali smo elektrokardiografske spremembe pri otrocih z erythema migrans in jih primerjali z elektrokardiografskimi ugotovitvami pri zdravih otrocih iz kontrolne skupine. V prospektivno raziskavo smo vključili 147 otrok z značilnim erythema migrans ter 148 zdravih otrok primerljive starosti in istega spola. Vsakemu bolniku in zdravemu preiskovancu smo posneli elektrokardiogram. Vse otroke smo razdelili v starostne skupine glede na srčno frekvenco, trajanje intervala PR, srčno os, trajanje in amplitudo intervala QRS, zobec Q, razmerje R/S, vala T in intervala QT. Za obdelavo podatkov smo uporabili z-test (Kruskal-Wallis) in x2 (Fischer). Patološki elektrokardiogram smo ugotovili pri 5% bolnikov in pri 14% zdravih preiskovancev (p=0,0303). V primerjavi z zdravimi preiskovanci so imeli bolniki krajše trajanje PR- in RR-intervala ter nižjo voltažo R- in S- zobca v V1. Patološki elektrokardiogram je bil pogostejši pri dečkih kot pri deklicah v obeh skupinah. (Izvleček prekinjen pri 2000 znakih)
Descriptors		LYME DISEASE ERYTHEMA CHRONICUM MIGRANS ELECTROCARDIOGRAPHY BORRELIA HEART DISEASES CHILD