Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico
Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico
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DOI：
10.1590/s0074-02762006000700005
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发表时间：
2006-11-01
期刊：
影响因子：
--
通讯作者：
Pérez-Fuentes, Ricardo
中科院分区：
文献类型：
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作者：
Sánchez-Guillén, María del Carmen;López-Colombo, Aurelio;Pérez-Fuentes, Ricardo
在墨西哥，尽管在某些地区人类克氏锥虫感染的血清阳性率相对较高，但报告的恰加斯病发病率尚不清楚。我们确定了71例血清学T阳性患者的临床分期。cruzi，墨西哥普埃布拉州，恰加斯病的地方性地区，报告的血清阳性率为7.7%。查加斯病的诊断通过两种标准化血清学试验（ELISA、IHA）进行。根据临床研究对个体进行分层。所有患者均接受心电图、吞钡和钡灌肠检查。组被确定为无异常证据的不确定形式（IF）无症状个体（n = 34例）;胃肠道改变者（12例患者）包括食管下括约肌异常松弛和食管体部无隆起、I级巨食管和/或巨结肠的症状;有慢性查加斯病临床表现和记录变化的患者，细分如下：轻度（8例患者）-心室复极轻度心电图变化，窦性心动过缓;中度（6例患者）-左束支分支阻滞，右束支分支阻滞伴左前分支阻滞）;重度（8例患者）-心脏肥大、扩张型心肌病的体征）;以及相关形式（3例病例），包括同时存在心肌病和巨食管。这些数据突出了准确评估墨西哥流行和非流行地区恰加斯病流行率和临床病程的重要性。
In Mexico, despite the relatively high seroprevalence of Trypanosoma cruzi infection in humans in some areas, reported morbidity of Chagas disease is not clear. We determined clinical stage in 71 individuals seropositive to T. cruzi in the state of Puebla, Mexico, an area endemic for Chagas disease with a reported seroprevalence of 7.7%. Diagnosis of Chagas disease was made by two standardized serological tests (ELISA, IHA). Individuals were stratified according to clinical studies. All patients were submitted to EKG, barium swallow, and barium enema. Groups were identified as indeterminate form (IF) asymptomatic individuals without evidence of abnormalities (n = 34 cases); those with gastrointestinal alterations (12 patients) including symptoms of abnormal relaxation of the lower esophageal sphincter and absent peristalsis in the esophageal body, grade I megaesophagus, and/or megacolon; patients with clinical manifestations and documented changes of chronic Chagas heart disease who were subdivided as follows: mild (8 patients) - mild electrocardiographic changes of ventricular repolarization, sinus bradychardia); moderate (6 patients) - left bundle branch block, right bundle branch block associated with left anterior fascicular block); severe (8 patients) - signs of cardiomegaly, dilated cardiomyopathy); and the associated form (3 cases) that included presence of both cardiomyopathy and megaesophagus. These data highlight the importance of accurate evaluation of the prevalence and clinical course of Chagas disease in endemic and non-endemic areas of Mexico.