冠心病高血压及无基础心血管病患者房性早搏对血流动力学的影响

目的：结合冠心病、高血压探讨房性早搏对血流动力学的影响。方法选择冠心病、高血压及无基础心血管病的房性早搏患者62例，根据房性早搏提前率将患者分为提前率小于20％组18例、20％～40％组20例和大于40％组24例。所有患者均行无创血流动力学检查，比较所有患者房性早搏时及房性早搏前、后第1个窦性心搏的各项血流动力学指标，并结合基础疾病对3组患者的房性早搏血流动力学变化率进行比较分析。结果房性早搏时心搏出量（SV）、心搏指数（SI）、主动脉血管顺应性（AC）、每搏作功（SW）、搏功指数（SWI）、心缩力指数（HI）均最小，房性早搏前第1个窦性心搏居中，房性早搏后第1个窦性心搏最大（P＜0．05）。房性早搏心搏出量、心搏指数、主动脉血管顺应性、每搏作功、搏功指数、心缩力指数降低程度在提前率小于20％组最小，20％～40％组居中，＞40％组最大（P＜0．05）。提前率小于20％组有冠心病、高血压尤其是冠心病合并高血压的患者所占的百分比最低，20％～40％组居中，＞40％组最高（P＜0．05）。结论房性早搏对血流动力学有一定影响，在合并基础心血管病的房性早搏患者中房性早搏提前率相对较大，且房性早搏提前率越大其对血流动力学的影响越大。

The effects of premature atrial contractions on hemodynamics with coronary heart disease and hypertension without basic cardiovascular disease

Objective To explore the effects of premature atrial contractions on hemodynamics combined with coronary heart disease and hypertension .Methods According to the advance rate ,62 patients with premature atrial contractions were invided into 3 groups :< 20% group(n= 18) ,20% - 40% group(n= 20) and > 40% group(n= 24) .All of the patients were performed imped‐ance cardiography .The hemodynamics indexes at different times were compared ,and the variation rates in hemodynamics of the three groups combined with basic diseases were analyzed .Results Stroke volume(SV) ,stroke index(SI) ,aortic compliance(AC) , stroke work(SW) ,stroke work index(SWI) ,and heather index(HI) were smallest when premature atrial contractions ,which were middle when the first sinus beats before premature atrial contractions ,and largest when the first sinus beats after premature atrial contractions(P< 0 .05) .The variation rates in hemodynamics were smallest in < 20% group ,which were middle in 20% - 40%group ,and largest in > 40% group(P< 0 .05) .The percentage of patients with basic heart diseases was lowest in < 20% group , which was middle in 20% - 40% group ,and highest in > 40% group(P< 0 .05) .Conclusion The advance rate is relatively large in patients with basic cardiovascular disease .Premature atrial contractions has certain effects on hemodynamics ,and the effects are positively correlated with advance rate .