慢性心力衰竭合并心房颤动发病的相关机制研究

The Relative Pathogenesis of Chronic Heart Failure Combined with Atrial Fibrillation

目的:慢性心力衰竭(Chronic Heart Failure,CHF)是心血管系统常见的疾病,威胁患者的生存周期及生活质量。本研究针对慢性心力衰竭合并房颤的临床特征,进一步探讨其发病机制,为临床治疗提供依据。方法:将80例慢性心力衰竭患者平均分为两组,心律正常的为窦性心律组,伴有心房颤动的作为房颤组。观察并比较两组的左心室射血分数(LVEF)和二尖瓣口舒张期流速(E/A)等心脏功能指标。结果:房颤组左心室射血分数(LVEF)为(0.42±0.08);二尖瓣口舒张期流速(E/A)为(0.65±0.22);左心房内径(LAD)为(53.4±8.2)mm。窦律组左心室射血分数(LVEF)为(0.45±0.09);二尖瓣口舒张期流速(E/A)为(0.72±0.17);左心房内径(LAD)为(46.7±7.9)mm。房颤组患者的LVEF和E/A值均低于窦律组,而LAD则明显高于窦律组,差异具有统计学意义(P<0.05)。房颤组醛固酮、血管紧张素(AngII)、脑钠肽(BNP)及超敏C反应蛋白(hs-CRP)均高于窦律组,差异具有统计学意义(P<0.05)。结论:慢性心力衰竭合并房颤的发病与患者体内神经内分泌体液系统水平和心脏结构功能有关,具体发病机制需进一步深入研究。

Objective： Chronic Heart Failure（CHF） is a common disease of cardiovascular system which threatens to the cycle and quality of life. This research aims to investigate the clinical features of chronic heart failure with atrial fibrillation and to analyze the pathogenesis of chronic heart failure complicated with atrial fibrillation so as to provide a basis for clinical treatment. Methods： 80 cases with chronic heart failure were selected and divided into two groups according to the proportion of 1：1. The patients with normal rhythm were chosen to be the sinus rhythm group, while others with atrial fibrillation were selected to be the atrial fibrillation group. Then the possible factors of atrial fibrillation were compared and analyzed. Results： The LVEF was （0.42＋ 0.08）; the E/A was （0.65_＋ 0.22）; the LAD was （53.4＋ 8.2） mm of the atrial fibrillation group. The LVEF was （0.45＋ 0.09）; the E/A was （0.72＋ 0.17）; the LAD was （46.7＋ 7.9） mm of the sinus rhythm group. The heart function indexes of the atrial fibrillation group were lower than those of the patients in sinus rhythm group, while the LAD was significantly higher than that of the sinus rhythm group with statistically significant differences （P〈0.05）. The aldosterone, AnglI, BNP, HS and CRP in atrial fibrillation group were higher than those of the patients in the sinus rhythm group with statistically significant differences （P〈0.05）. Conclusion： The pathogenesis of chronic heart failure complicated with atrial fibrillation is related to the neuroendocrine fluid system level and cardiac structure and function, but the specific mechanism needs further study.