老年心房颤动患者的冠状动脉病变分析

目的观察老年患者心房颤动(房颤)的发生与冠心病的关系。方法根据我院1990年以来的尸检资料,选择75岁以上生前有房颤发作记录的76例患者作为房颤组,平均年龄(86.9±6.9)岁,临床均诊断有冠心病;选择与房颤组年龄相近、临床无房颤记录、经尸检病理证实为冠心病的85例患者作为冠心病组,比较两组患者冠状动脉的病变情况。结果房颤组中38例患者经病理证实有冠心病,心肌梗死发生率为39.5%,冠心病组心肌梗死发生率为62.4%,两组比较有统计学差异(P<0.01);房颤组与冠心病组心脏重量、左心室壁厚度分别为(437.5±80.6)%(434.6±90.3)g,P>0.05;(1.42±0.33)%(1.42±0.38)cm,P>0.05];房颤组冠状动脉达Ⅲ级病变和Ⅳ级病变的血管数量(40 vs.99、27 vs.52,P<0.001)明显少于冠心病组。结论老年患者心房颤动的发生与冠心病之间不存在明确的因果关系。

Analysis of the coronary artery pathological changes in elderly patients with atrial fibrillation

Objective To determine the association between atrial fibrillation(AF)and coronary artery disease(CAD) in elderly patients.Methods Based on autopsy data from 1990,76 patients with over 75 years old and AF history and diagnosed as CAD clinically were selected as AF group,Other 85 age-matched patients with pathologically approved CAD and without AF history were selected as the control group.The pathological changes of the coronary arteries between the groups were compared.Results Thirty-eight patients in AF group were diagnosed as CAD, the morbidity of myocardial infarction were 39.5% in AF group and 62.4% in the control(P<0.01);The heart weight and left ventricle thickness(437.5±80.6)vs.(434.6±90.3)g,P>0.05;(1.42±0.33)vs.(1.42± 0.38)cm,P>0.05]between two groups were similar;The AF group had fewer branches of arteries(40 vs.99,27 vs.52;P<0.001)with pathological lesion Ⅲ and lesionⅣ than did the control.Conclusions The occurrence of AF in elderly patients is not in relation to the CAD.