二尖瓣狭窄与心房纤颤：血流动力学与超声心动图研究

为探讨二尖瓣狭窄患者肺循环血流动力学、病程与心房纤颤之间的关系，利用心导管技术结合超声心动图测量８０例二尖瓣狭窄患者平均肺动脉压、左房压、右房压、跨瓣压、左右心室收缩压和舒张压、左室内径、左房内径、瓣口面积。结果表明：持续性房颤患者左房内径大于窦性心律患者（Ｐ＜０．０００１），也大于阵发性房颤患者（Ｐ＜０．０５），持续性房颤患者左右室舒张压和病程也明显大于窦性心律者。皮尔逊相关系数和多元逐步回归分析进一步证明，房颤与左房内径大小及病程长短有关。本文对心房纤颤发生机理进行初步探讨。

Atrial Fibrillation in Rheumatic Mitral Stenosis :Hemodynamic and Echocardiographic study

To Study the relationship between the Hemodynamics Echocardiographyhemodynamics of pulmonary circulation,the courseof disease and atrial fibrillation in the patients ofrheumatic mitral stenosis,80 patients were dividedinto three groups:Group A 30 patients with sinusrhythm;Group B 30 patients with chronic atrial fib-rillation;Group C 20 patients with intermittent atrialfibrillation.Cardiac catheterization and Doppler e-chocardiography were performed. The results showed that there were no differ-ences among the groups in mean pulmonary arterialpressure, left and right atrial pressure,transvalvepressure,left and right ventricular systolic and dias-tolic pressure,mitral valve orifice area,and left ven-tricular dimension. The left atrial dimension (LAD)in group B was significantly larger than that of groupA(P<0.0001)and group C (P<0.05).In group B,the left and right ventricular diastolic pressure wasSignificantly higher than that of group A(P<0.01 )and group C(P<0.05).In group B, the course ofdisease was longer than that of group A(P<0.05)and group C(but P>0.05).The results of Pearsoncorrelation coefficient and multiple regression analy-sis suggested that the atrial fibrillation of rheumaticmitral stenosis was well correlated with the course ofdisease and LAD.The pathogenesis of atrial fibrilla-tion was discussed.