非心源性病变心律失常146例临床分析

Analysis of non-cardiac arrhythmias in 146 cases

目的:探讨非心源性病变心律失常的临床特点及治疗,提高对此类心律失常的认识,以减少误诊。方法:回顾性分析146例非心源性病变心律失常患者的临床表现、导致心律失常的原发疾病,以及针对性治疗原发疾病后心律失常的转归。结果:146例非心源性疾患分别为颈椎病38例(26.0%)、隐性甲亢31例(21.2%)、恶性肿瘤18例(12.3%)、心脏神经官能症16例(11.0%)、胆道疾病15例(10.3%)等;心律失常以早搏及心动过速为主,患者常伴有心悸、胸闷、焦虑、多汗及心前区疼痛等症状;≥60岁患者容易误诊为冠心病,<60岁的患者容易误诊为心肌炎,差异有统计学意义(P<0.05)。针对性治疗原发疾病后,心律失常绝大多数都能很快缓解、消失,尤其是恶性肿瘤切除后心律失常可迅速缓解。结论:很多非心源性疾患可致心律失常,此类患者常伴有原发疾病的临床表现,对原发疾病的治疗可使心律失常很快缓解、消失。

Objective：To investigate the clinical features and effective treatments for non-cardiac arrhythmia（NCA）in order to reduce misdiagnosis.Methods：Clinical manifestations,primary disease leading to arrhythmias,and the outcomes of treatments in 146 NCA cases were retrospectively analyzed.Results：Primary disease of the 146 NCA included cervical spondylosis in 38 cases（26.0%）,latent hyperthyroidism in 31 cases（21.2%）,malignant tumor in 18 cases（12.3%）,cardiac neurosis in 16 cases（11.0%） and biliary disease in 15 patients（10.3%） etc.The most common symptoms were palpitation,chest stuffiness,anexity,hydrosis and praecordia pain in these patients.NCA in elderly patients over 60 years were often misdiagnosed as coronary heart disease,while younger patients were often misdiagnosed as myocarditis,there was significant differences（P0.05）.After symptomatic treatments for the primary diseases,most NCA can be relieved and disappeared quickly,especially those with malignant tumor.Conclusions：Many non-cardiac diseases can lead to arrhythmias,most of which are accompanied by clinical manifestations of the primary disease.After symptomatic treatments for the primary diseases,most NCA can be relieved and disappeared quickly.