老年原发性高血压并心房颤动患者左心房病变分析

Analysis of left atrial lesions in elderly patients with essential hypertension and atrial fibrillation

目的探讨老年原发性高血压合并房颤患者左心房病变情况，为临床治疗此类患者提供指导。方法回顾分析110例老年原发性高血压合并房颤患者的临床资料，其中阵发性房颤42例（阵发性房颤组）、非阵发性房颤68例（非阵发性房颤组）。收集患者心脏超声断面图收缩期左心房前后径（LAD）和左室射血分数（LVEF）等资料，并进行比较。结果阵发性房颤组LAD为（3612±5．3）mm，非阵发性房颤组LAD为（38．1±4．8）mm，二者相比差异有统计学意义（P〈0．05），室间隔舒张末期厚度（ws）、LVEF比较未见统计学差异（P〉0．05）；多元线性回归分析发现房颤的发生和维持与血压、年龄及LAD相关。结论老年原发性高血压合并房颤患者可出现显著的左心房扩大。年龄、高血压、左心房扩大均为心房颤动的危险因素。

Objective To investigate the situation of left atrial lesions in elderly patients with essential hypertension complicated with atrial fibrillation Methods A retrospective analysis of elderly hypertensive patients with atrial fibrillation were 110 cases, including 42 eases of paroxysmal atrial fibrillation, 68 cases of non-parox- ysmal atrial fibrillation. Data of the left atrial diameter （LAD） and left ventricular ejection fraction （LVEF） were collected and compared with that of the left atrial diameter and left ventrieular ejection fraction. Results LAD were（36.2±5.3 ）mm and （38.1±4.8）mm in paroxysmal atrial fibrillation group and non-paroxysmal atrial fibrillation group, the difference was statistically significant （P〈0.05）,but the interventricular septum （IVS）, end-diastolic thickness, left ventricular ejection fraction（LVEF） were no difference（P〉0.05 ）. Multiple linear regression analysis found that the occurrence of atrial fibrillation and maintaining associated with blood pressure, age and LAD. Conclusion Elderly patients with essential hypertension and atrial fibrillation may occur significant left atrial en- largement, and age, hypertension, left atrial enlargement are all risk factors for atrial fibrillation.