老年高血压与室性心律失常及左室肥厚的关系

Prevalence of ventricular arrhythmias as and it’s relations with Left ventricular hypertrophy in elderly hypertensive Patients

目的：探讨老年高血压患者室性心律失常特点及与左室肥厚的关系。方法：对原发性高血压２７４例（老年组１８４例，非老年组９０例）和１３２例健康人为对照组（老年组７０例，非老年组６２例）行２４ｈ动态心电图和超声心动图检测。结果：室性心律失常发生率在高血压老年组为７５％，非老年组为５１．１％，对照组为４８．６％和４．８％，其中Ｌｏｗｎ’ｓ分级≥３的室性心律失常在高血压老年组和非老年组分别为３２．１％和２１．１％，对照组２．９％和０％（Ｐ均＜０．０１），在高血压老年组中６０例伴左室肥厚，其总室性心律失常发生率和Ｌｏｗｎ’ｓ分级≥３者达９１．７％和６６．７％，均高于无左室肥厚的６９．４％和１８．８％（Ｐ均＜０．０１）。结论：老年高血压患者室性心律失常发生率及严重程度显著高于非老年高血压患者和同年龄组的正常人。左室肥厚者更易发生室性心律失常，是猝死率高的重要原因。

Objective:To investigate the prevalence and Significance of ventricular arrhythmias and its relations with left ventricular hypertrophy elderly hypertensive patients.Methods:274 cases of essential hypertension (elderly group:184 cases;non-elderly group:90 cases)were examined with echocardiography and monitored with 24 hour ambulatory electrocardiogram,132 healthy subjects(elderly group:70 subjects;non-elderly group:62 subjects) as controls.Results:The incidences of ventricular arrhythmias were 75% in elderly hypertensive group,51.1% in non-elderly hypertensive group,48.6% and 48% in control elderly group and non-elderly group respectively;Lown's grade≥3 ventricular arrhythmias were 32.1% and 21.1% in elderly hypreitensive group and non-elderly hypertensive group respectively,2.9% and 0% in control(group cp<0.01 respectively).In elderly hypertensive patients,60 cases with left ventricular hypertrophy(LVH)and 124 case without LVH,the incidences of ventricular arrhythmias (VA) and VA with Lown’s grade≥3 were 97.7% and 66.7% Vs 69.4% and 18.5% respectively (P<0.001 respectively).Conclusion:The incidences and severe degree of ventricular arrhythmias in elderly hypertensive patients were higher than that in non-elderly hypertensive patients and same ages healthy subjects.Ventricular arrhythmias more frequently occurres in elderly hypertensive patients with left ventricular hypertrophy and was an important cause of sudden death in the elderly patients.