冠状动脉血流储备与高血压左室肥厚患者室性心律失常的关系  

The possible relationship between ventricular arrhythmias and coronary flow reserve in hypertensive patients with left ventricular bypertrophy

作　　者：林金秀[1] 陈达光[1] 陈济添[1] 阮琴韵[1] 叶琼 林赛榕[1] 

机构地区：[1]福建医学院附属第一医院心内科,福建医学院附属第一医院超声心动图室,福建医学院附属第一医院胃镜室

出　　处：《临床心血管病杂志》1996年第1期5-8,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金

摘　　要：对２２例正常人（Ａ组）、３０例高血压无左室肥大（ＬＶＨ）的病人（Ｂ组）及４０例高血压伴ＬＶＨ的病人（Ｃ组）的冠状动脉血流储备（ＣＦＲ）用经食道多普勒超声的方法进行了检查，以研究室性心律失常的发生与高血压伴ＬＶＨ及ＣＦＲ的可能关系。研究发现，与Ｂ组病人相比，Ｃ组病人ＣＦＲ显著降低，室性心律失常及复杂室性心律失常的发生率显著增高（分别为９０％，６０％比３０％，１０％，Ｐ＜０．０１）；Ｃ组病人中有ＣＦＲ降低者室性心律失常及复杂室性心律失常的发生率最高（９６．８％及６７．７％）．Ｃ组病人中无ＣＦＲ降低者，其室性心律失常及复杂室性心律失常之发生率与高血压无ＬＶＨ但有ＣＦＲ降低者相似（分别为６６．７％，２２．２％及６０％，２０％）。研究结果提示，在高血压病人ＬＶＨ及ＣＦＲ降低是室性心律失常发生的两个相加作用的危险因素。Coronary blood flow reserve(CFR)of 22 normal subjects(group A),30 hypertensives without left ventricular hypertrophy(non-LVH)patients(group B)and 40 hypertensive patients with LVH(group C)were investigated with transesophageal Doppler echocardiography(TEE)(Iliceto's method).The possible relationship between occurrence of ventricular arrhythmias(VA)and CFR in patients with hypertensive LVH was studied.It was found that CFR was significantely decreased in group C compared with group B,me anwhile incidence of VA and com plex VA were higher in group C(90%,60%)than those in group B(30%,10%.P<0.01 respectively).The incidence of VA and complex VA were highest in hypertensive patients with LVH acccompanied with decreased CFR(96.8%,67.1%),but had no difference of incidence of VA and complex VA between hypertensive patients with LVH and normal CFR(66.7%,22.2%),and non-LVH with impaired CFR (60%,20%).The results suggested that LVH accompanied with decreased CFRwere two additive risk factors for occurrence of ventricular arrhythmias in patients with hypertension.

关 键 词：高血压 左室肥厚 冠状动脉 血流储备 心律失常 

分 类 号：R544.106[医药卫生—心血管疾病] R541.702[医药卫生—内科学]