不同年龄段病态窦房结综合征的特点分析

Characteristics of sick sinus syndrome in different age groups

目的:分析不同年龄段病态窦房结综合征(SSS)的特点。方法:选取2014至2021年于郑州大学第一附属医院就诊并确诊SSS的患者共110例,按15~<50岁、50~<60岁、60~<70岁及70~82岁分为4组。110例中71例有动态心电图(DCG)结果。比较不同年龄段患者SSS分型、有关窦房结电生理指标及DCG指标。采用Pearson相关分析年龄分别与24 h最快心率、24 h最快最慢心率差值的相关性。结果:15~<50岁及50~<60岁患者SSS以单纯病窦型为主(分别占79.2%及70.6%);60~<70岁及70~82岁患者慢快综合征型占比分别达54.5%与52.6%;双结病变型仅4例,其中70~82岁组2例,占比10.5%。70~82岁组房室交界区前传文氏点高于其他组,前传文氏点降低的发生率明显下降(P<0.05)。24 h最快最慢心率差值随年龄的增长进行性下降(P<0.05)。相关分析显示年龄分别与24 h最快心率、24 h最快最慢心率差值负相关(r=-0.336和-0.376,P均<0.05)。结论:<60岁的SSS患者以单纯病窦型为主,60岁以上患者慢快综合征型占比约50%,70岁以上患者双结病变型比例增加;随着年龄增长,逐渐出现窦房结变时功能不全。

Aim:To analyze the characteristics of sick sinus syndrome(SSS)in different age groups.Methods:A total of 110 patients diagnosed with SSS in the First Affiliated Hospital of Zhengzhou University from 2014 to 2021 were enrolled.Among whom,71 patients had the results of dynamic electrocardiogram(DCG).All the patients were allocated into 4 groups by age(15-<50 years,50-<60 years,60-<70 years and 70-82 years).Clinical classification of SSS,electrophysiological data of sinoatrial node and the data of DCG were analyzed among the different age groups.Results:The majority of SSS in patients aged 15-<50 years and 50-<60 years were simple sick sinus type(79.2%and 70.6%,respectively),54.5%and 52.6%of patients aged 60-<70 years and 70-82 years were slow-fast syndrome type,and there were only 4 cases of double-nodular lesions type,of whom 2 cases were>70 years,accounting for 10.5%.In 70-82 years group,the Wenckebach block point of atrioventricular junction was higher than that in other groups,and the incidence of decreased Wenckebach block point was lower(P<0.05).The difference between the fastest and slowest heart rates of 24-hour decreased progressively with the increase of age(P<0.05).The results of correlation analysis showed that age was negatively correlated with 24-hour fastest heart rate and the difference between the fastest and slowest heart rates of 24-hour(r=-0.336,-0.376,P<0.05).Conclusion:The majority of SSS patients under 60 years old are simple sick sinus type,and the proportion of slow-fast syndrome type in patients over 60 years old is about 50%.The proportion of double-nodular lesions type increases in patients over 70 years old.With the increase of age,there is a gradual onset of chronotropic incompetence of sinoatrial node.