高血压病心律失常发生机制的临床分析

目的分析高血压病心律失常的发生机制。方法对100例高血压病患者和20例健康者的超声心动图、24小时动态心电图和临床资料进行比较。结果(1)高血压病患者的左心房(左房)增大,并随年龄增大,高血压病史延长,左房扩大越明显,发生严重房性心律失常几率也越高。高龄组发生持续性房颤为30.77%,显著高于其他年龄组。(2)室性心律失常发生率为36%(36例),房性心律失常发生率为85%(85例)。(3)多元回归分析显示:高血压病患者房性心律失常的发生与左房的大小、二尖瓣返流、左室大小以及左室质量指数相关,尤其与左房大小的相关性更明显,室性心律失常与左房、二尖瓣返流、主动脉瓣返流、左室质量指数相关性不显著,而与左室腔大小相关。结论(1)年龄、高血压病史、左房大小是影响高血压房性心律失常的重要因素,二尖瓣返流、左室增大、左室质量指数增高也与发生房性心律失常相关。(2)高血压患者室性心律失常发生率低于房性心律失常,高血压离心性心脏扩大比向心性肥厚更容易发生室性心律失常。

To study the mechanism of arrhythmia in hypertension

Objective To analyse the mechanism of arrhythmia in hypertensive patients.Methods The echocardiographies,24-hour dynamic eletrocardiogram and clinical data of 100 hypertensive patients and 20 healthy subjects were analysed.Results(1)Left atrium was larger in hypertensive patients than in healthy subjects.The older,the longer hypertensive history,the larger left atrium,the higher fenqency of atrial arrhythmia.Chronic atrial fibrillation rate was 30.77% in 80 years old group,higher significantly than other groups.(2)In the hypertensive patients ventricular arrhythmia happened in 36% and atrial arrhythmia occurred in 85%.(3)The multiple regression analysis showed the incidence of atrial arrhythmia was correlated with left atrial size,mitral regurgitation(MR),left ventricular size and left ventricular mass index(LVMI),especially left atrial size.The incidence of ventricular arrhythmia was no significantly correleted with left atrial size,MR,aortic regurgitation(AR) and LVMI,but was correlated with left ventricular size.Conclusion(1)Age,hypertensive history and left atrial size were important impact factors of atrial arrhythmia.MR,left ventricular size and LVMI were correlated with atrial arrhythmia.(2)The fenqency of ventricular arrhythmia was significantly lower than atrial arrhythmia.The incidence of ventricular arrhythmia was higher in concentric hypertrophy than in eccentric hypertrophy.