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醫(yī)學(xué)領(lǐng)域1970年才開(kāi)始有人利用超導(dǎo)體磁性計(jì)量器檢測(cè)腦部病
變時(shí)的生物磁場(chǎng)變化。近年來(lái)發(fā)展較快,1983年意大利學(xué)者發(fā)明了磁性腦電圖(MEG),應(yīng)用單頻道RF薄片超導(dǎo)量子干預(yù)裝置(sQuID)的二級(jí)序列梯度計(jì)量顯像描記,檢查局限性癲痛患者。
根據(jù)美國(guó)心臟協(xié)會(huì)雜志Circulation上的一項(xiàng)研究,一種切實(shí)可行的技術(shù)可使醫(yī)生有能力對(duì)一個(gè)死產(chǎn)和嬰兒猝死的常見(jiàn)病因進(jìn)行診斷,并有可能在子宮中 對(duì)其進(jìn)行治療。這項(xiàng)研究是第一次在一個(gè)可觀有風(fēng)險(xiǎn)人群中記錄嬰兒長(zhǎng)QT綜合征的電生理特征,并評(píng)價(jià)磁性心電圖或心磁波描記圖的診斷準(zhǔn)確性。
一個(gè)記錄心臟的天然磁活動(dòng)裝置可幫助研究者識(shí)別未出生嬰兒的異常心律。這項(xiàng)研究是第一次在一個(gè)可觀有風(fēng)險(xiǎn)人群中記錄嬰兒長(zhǎng)QT綜合征的電生理特征。
此項(xiàng)研究的主要研究者Ronald T. Wakai博士指出,“直到現(xiàn)在,醫(yī)師們還無(wú)法在嬰兒出生前診斷一種稱作長(zhǎng)QT綜合征的嚴(yán)重心臟病,這項(xiàng)研究顯示,你可以在子宮中診斷此類情況,并辨認(rèn)有患威脅生命的心律失??赡艿奶骸Q芯客瑫r(shí)顯示,心律失常一經(jīng)檢測(cè)就可在子宮中被有效治療。”
Wakai指出,長(zhǎng)QT綜合征大約在每2000個(gè)新生兒中會(huì)出現(xiàn)一例,并且約占嬰兒猝死和不明原因死產(chǎn)的10%,它是兒童和青少年猝死的一個(gè)主要原因。長(zhǎng)QT使心臟傾向于發(fā)展為一種潛在致命心律,但如果此心律能夠被辨認(rèn)出,嬰兒就有可能被成功治療。應(yīng)用電磁心電圖,研究者們?cè)谧訉m中診斷長(zhǎng)QT的準(zhǔn)確性為89%.
研究者們?cè)u(píng)價(jià)了1996-2012間威斯康星洲和日本的兩個(gè)地方的30位孕婦。他們根據(jù)長(zhǎng)QT綜合征家族史、兄弟姐妹中嬰兒期或兒童期不明原因死亡或可疑的胎兒心律來(lái)選擇患者。研究者們繼而早在孕中期就在母親腹部的放置了探針并收集了其數(shù)據(jù)。其中,21位嬰兒被診斷為長(zhǎng)QT綜合征,6位嬰兒存在危險(xiǎn)心律,其中有一位在惡性心律被發(fā)現(xiàn)后早期就被生下。
Wakai認(rèn)為,電磁心電圖會(huì)被在“不遠(yuǎn)的將來(lái)”得到實(shí)際應(yīng)用,但準(zhǔn)確完整的家族史仍是診斷長(zhǎng)QT綜合征最關(guān)鍵的方面。
注:
共同作者有Bettina F. Cuneo, M.D.; Janette F. Strasburger, M.D.; Suhong Yu, Ph.D.; Hitoshi Horigome, M.D.; Takayoshi Hosono, M.D.; 并且Akihiko Kandori, Ph.D. Author disclosures也在手稿中提到。這項(xiàng)研究由美國(guó)**衛(wèi)生研究院資助。
原文:
Device may help doctors diagnose lethal heart rhythm in womb
American Heart Association Rapid Access Journal Report
November 11, 2013
Study Highlights:
A device that records the natural magnetic activity of the heart helped researchers identify abnormal heart rhythms in unborn babies.
It's the first sizable study to document the electrical aspects of long QT syndrome in the womb.
The condition is a common cause of sudden death in early life and stillbirth.
DALLAS, Nov. 11, 2013 — A promising technology may enable doctors to diagnose and possibly treat in utero a common cause of stillbirth and sudden death in infants, according to research published in the American Heart Association journal Circulation.
The study is the first to document the electrophysiological characteristics of fetal long QT syndrome and to evaluate the diagnostic accuracy of the magnetic EKG, or magnetocardiogram, in a sizable population of at-risk fetuses.
“Until now, physicians were unable to diagnose a serious heart condition known as long QT syndrome until after birth,” said Ronald T. Wakai, Ph.D., principal investigator of the study and a professor of medical physics at the University of Wisconsin School of Medicine and Public Health in Madison. “Our study shows that you can diagnose the condition in utero and identify which fetuses are most likely to have life-threatening arrhythmia. We also showed that once detected the arrhythmia can be effectively treated in utero.”
Long QT syndrome is present in about one in every 2,000 births and accounts for about 10 percent of sudden infant deaths and unexplained stillbirths, Wakai said. It's also a leading cause of sudden death in children and young **s. Long QT predisposes the heart to develop a potentially lethal heart rhythm, but fetuses can be successfully treated if the rhythm is identified.
Using the magnetic EKG, the researchers diagnosed long QT in the womb with 89 percent accuracy.
The researchers evaluated 30 pregnancies in 1996-2012 in Wisconsin and at two locations in Japan. They chose patients based on a family history of long QT syndrome, unexplained death of a sibling in infancy or childhood, or a suspicious fetal heart rhythm. They then collected data positioning a probe on the mother's abdomen as early as midway through the pregnancy.
Long QT syndrome was diagnosed in 21 of the fetuses. Six of the fetuses had dangerous heart rhythms and one was delivered early after ominous rhythms were noted.
Magnetic EKGs will be put into practical use in the “not-too-distant future,” but an accurate and complete family history remains the most critical aspect of diagnosing long QT syndrome, Wakai said.
Co-authors are Bettina F. Cuneo, M.D.; Janette F. Strasburger, M.D.; Suhong Yu, Ph.D.; Hitoshi Horigome, M.D.; Takayoshi Hosono, M.D.; and Akihiko Kandori, Ph.D. Author disclosures are on the manusc**t.
The National Institutes of Health funded the study.
For the latest heart and stroke news, follow us on Twitter: @HeartNews.
For updates and new science from Circulation, follow @CircAHA.
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