【摘要】 目的:评价高血压病患者合并不同类型心房颤动(房颤)时心脏结构及功能变化特点。方法:入选高血压病不伴房颤75例(A组)、伴阵发性房颤30例(B组)、伴持续或永久性房颤20例(C组)。所有患者均行24h动态心电图检查判定心律失常情况,多普勒超声心动图检查评价心脏结构和功能,同时用干式快速免疫荧光法定量测定血浆B型钠尿肽(BNP)浓度,协助评估心功能。结果:(1)3组间,C组的左心房内径(LAD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室收缩末期内径(LVESd)、左室舒张末期内径(LVEDd)、左室质量指数(LVMI)、左心室室壁相对厚度(RWT)、血浆BNP浓度最大,左室射血分数(LVEF)最低,且均与其他2组有统计学差异(P<0.05);(2)B组的LAD、IVST、LVPWT、LVESd、LVEDd、LVMI、RWT、LVEF、血浆BNP浓度大于A组,但仅LAD、LVMI、血浆BNP浓度达统计学差异(P<0.05)。结论:高血压病患者合并房颤时左心结构及功能发生明显变化,且以合并持续或永久性房颤时最显著。更多还原

【Abstract】 Objective To investigate the changes of heart structure and function in patients with essential hypertensive(EH) complicated with atrial fibrillation(AF).Methods All 125 patients with EH were recruited which included EH without AF(Group A,n = 75),EH with paroxysmal AF(Group B,n = 30),EH with persistent or permanent AF(Group C,n = 20).The arrhythmias were monitored by 24-houre ambulatory electrocardiogram,while the heart structure and function were evaluated by Doppler-chocardiography.Plasma level of B-type natriuretic peptide(BNP) was measured by a point-of-care immunoassy.Results The left atrial diameters(LAD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end systolic diameters(LVESd),left ventricular end diastolic diameters(LVEDd),left ventricular mass index(LVMI),relative left wall thickness(RWT),and plasma level of BNP in Group C were the highest,and the left ventricular ejection fraction(LVEF) was the lowest,and were significantly different from those in Group A and B(P < 0.05).The LAD,LVMI,and plasma level of BNP in Group B were greater than those in Group A(P < 0.05).Conclusion Heart structure and function were changed in patients with EH complicated with AF,especially in those complicated with persistent or permanent AF.更多还原