老年患者心脏结构与心律失常的关系

The Relationship Between Arrhythmia And Cardiac Structure in Senile

目的：通过24h动态心电图（DCG） 检测及彩色多普勒超声测定探讨老年人心律失常与心脏结构及心功能的关系.方法：收集老年科2004年5月至2006年10月住院的行24h动态心电图（DCG） 检测及彩色多普勒超声测定患者共301例,其中男245例,女56例,年龄60～95岁,平均年龄（80.11±5.30）岁.根据DCG检测分心律失常组与非心律失常组.心律失常指房性早搏＞100次/d,室性早搏＞100次/d.心律失常组分房性心律失常组、室性心律失常组及混合性心律失常组.用彩色多普勒超声测定心脏房室内径及左心室重量指数（LVMI）,左心室射血分数（LVEF）.把心律失常、非心律失常及心律失常类型与心脏结构及心功能进行对比分析.结果：301例老年患者发生心律失常198例,心律失常组与非心律失常组比较房、室增大有显著差异（P＜0.01）,LVMI增加有差异（P＜0.05）,LVEF降低无差异.房性心律失常与室性心律失常进行分析比较,前者以左心房增大为主,后者以左心室增大或同时并左心房增大为主（P＜0.05）.结论：老年心律失常的发生与心脏扩大、心功能不全密切相关,在此心脏结构改变基础上,各种心律失常的发生也随之增加.因此在处理心律失常时,应积极治疗原发病,改善心功能,防止心脏扩大.

Objectives： To analyze the relationship between arrhythmia cardiac according to the results of DCG and ultrasound cardiogram in senile. Method： To collect the results of DCG and utrasound cardiogram of 301 elderly patients in our department from May 2004 to Oct. 2006. Among them,245 cases were male,56 cases were female. The mean age was 80.11 yearold. Through the results of DCG, 301 cases were divided into two groups, arrhthmia group and control group. The arrhythmia group were divided into three groups, atrical arrhythmia group,ventricular arrhythmia group and mixed group. To detect the internal diameter of atrium and ventricle, LVMI and LVEF. Then compared and analyzed the cardiac structure and the cardiac function between arrhythmia group and control group, also between the three arrhythmia groups. Result： There＇s 198 cases had arrhythmia. The incidence of atrial or ventrical enlargement was higher in the arrhythmia group than thise in control group（ P 〈0.01 ）. There＇s difference of LVMI between the arrhythmia group and control group （ P 〈 0.05 ）, but no difference of LVEF. The left atrial enlargement happened mostly in atrial arrhythmia group, also, the left ventrical enlargement or/and left atrical enlargement happened mostly in ventrical arrhythmia group （ P 〈 0.05）. Conclusion： The incidence of elderly arrhythmia relate to cardiac enlargement, cardiac function. With the severe increasing of the the cardiac structure change, the incidence of all kinds of arrhythmia are raising. So when deal with the arrhythmia, we should treat the original diseases and prove the cardiac function to prevent the cardiac enlargement.