高血压病左室肥厚的室性心律失常的意义探讨

Study of Significance of Ventricualr Arrhythmias in Hypertension with Left Ventricular Hypertrophy

对１２９例高血压病患者进行连续２４小时动态心电图监测，分析室性心律失常的发生，结果表明，伴左室肥厚高血压病组（ｎ＝４８）复杂室性心律失常（按Ｌｏｗｎ分级≥Ⅲ级）的发生率为７０．８％（３４／４８）显著高于无左室肥厚的高血压病组（ｎ＝８１）的１３．６％（１１／８１）；复杂室性心律失常昼夜变化以晨６时至正午１２时发生较多。提示伴左室肥厚的高血压病有复杂室性心律失常易发性及心律失常源的基础，积极逆转左室肥厚、改善心肌缺血及室性心律失常的治疗，对心性猝死的预防可能有重大意义。

Ventricular arrhythmias was detected in 129 hypertensive patients by undertaking 24-hour ambulatory ECG monitoring.A comparative analysis of 48 patients with left ventricular hypertrophy (group A) and 81 patients without left ventricular hypertrophy(group B) showed that the incident rate of complex ventricular arrhythmias (Lown grade≥Ⅲ)in group A (70.83%)was higher than that in proup B(13.58%).This difference was statistieally significant (P<0.005).The interval from 6:00 a.m.to noon revealed a higher prevalence of complex ventricular arrhythmia than at other time of the day.The significance of complex ventricular arrhythmias in hypertensive patients with left ventricular hypertrophy may mean increased risk of sudden cardiac death.Therefore intensive therapy should be given for comple ventricular arrhythmias in hypertensive patients with left ventricular hypertrophy.