高血压病左房、室构型与心律失常

目的 探讨高血压病患者左房、室构型情况及其与心律失常的关系。方法 95例高血压病患者（EH组）依年龄分为＜60岁和≥60岁两亚组。全组经彩色超声心动图检测左房内径（LAD），左室重量指数（LVMI）；经动态心电图（Holter）判定心律失常，并将相关指标进行对比分析。结果 EH组中检出左房扩大（LAE）63例（66.3％），左室肥顾（LVH）45例（47.4%)，两者比较有差异（P＜0.05）；其中单纯左房扩大37例，单纯左室肥厚19例，左房扩大并左室肥厚（LEH）26例，与对照组比较P＜0.01。EH组中≥60岁单纯左房扩大、左室肥厚及左房扩大并左室肥厚发生率与＜60岁亚组比较P＜0.05。EH组检出室性心率失常（VA）54例（56.8%）,房性心律失常（AA）71例（74.7％），两才有显著性差异（P＜0.05）。EH组年龄≥60岁各种房、室性心律失常发生率与＜60岁比较P＜0。05。结论 高血压病除存在LVH外，还存在左房扩大并左室肥厚，其发生率高于左室肥厚。高血压病左房、室构型与心律失常有关，房性心律失常高于室性心律失常；老年高血压病者比中年人更易发生左房、室内型改变及各种心律失常。

Relationship of left atrial and left ventricular patterns with arrhythmias in hypertension

Objective To study the relationship between left atrial and ventricular patterns and arrhythmias in hypertension.Methods 95 hypertensive patients were divided according to their ages into two groups:Group A (those less than 60 years old)and Group B (60 or more).Their left atrial dimension (LAD) and left ventricular mass index (LVMI) were measured by plused doppler echocardiograph,and their arrhythmias were monitored by Holter dynamic electrocardiogram.And the results were contrastively analyzed with other indexes concerned.Results 63(66.3%) cases were determined having left atrial enlargement (LAE) and 45(47.4%) having left ventricular hypertrophy (LVH)(P<0.05 between the two figures).37 cases were found with pure LAE;19 cases with pure LVH and 26 cases with LAE accompanied by LVH(LEH).Comparison with the non hypertension group showed P<0.01.Group A were compared with Group B about their incidence of pure LAE,LVH and LEH,showing P<0.05. 54 (56.8%) cases were detected with ventricular arrhythmia (VA) and 71(74.7%) cases with atrial arrhythmia (AA) with signifi cant difference.Comparison between Group A and Group B concerning their VA or AA showed P<0.05.Conclusion Hypertension should include not only LVH but also LAE which has a higher incidence.The occurance of arrhythmias is correlated to the left atrial and ventricular structure changes and more frequently appear in elderly patients with hypertension.