老年前期和老年高血压病患者心律失常特点及其与左室肥厚的关系  

Prevalence of arrhythmias and its relations with left ventricular hypertrophy in presenile aud senile hypertensive patients

作　　者：郑勇[1] 王长溪[1] 李维绥[1] 赖鹏斌 

机构地区：[1]福建医学院附属第一医院内三科,福建医学院附属第一医院物理诊断科

出　　处：《临床心血管病杂志》1996年第1期9-12,共4页Journal of Clinical Cardiology

摘　　要：分析老年前期８２例、老年期１２４例高血压病患者和健康老年前期４６例、老年期６３例的２４小时动态心电图心律失常特点。结果显示老年前期高血压组总房性心律失常和总室性心律失常发生率分别为９０．２％和５９．８％，老年高血压组分别是９８．４％和７５．０％，差异显著（均Ｐ＜０．０１）；老年前期对照组分别为８０．４％和４５．７％，与同期高血压组比较差异不显著（均Ｐ＞０．０５）；老年对照组分别为８７．３％和５２．３％。与同期高血压组比较差异显著（均Ｐ＜０．０１）。老年高血压组中伴左室肥厚（ＬＶＨ）者（６６例）其总室性心律失常和Ｌｏｗｎ’ｓ分级≥３级室性心律失常发生率分别是８４．８％和３６．４％，均高于不伴ＬＶＨ者（５８例）的６３．８％和１３．８％（Ｐ＜０．０１）。在老年前期高血压组中伴ＬＶＨ者其Ｌｏｗｎ’ｓ分级≥３级室性心律失常发生率为１９．０％，高于不伴ＬＶＨ者的２．５％（Ｐ＜０．０５）．提示室性心律失常的发生与ＬＶＨ密切相关。Twenty-four-hour ambutatory electrocardiographic examinations were performed in 82 presenile hypertensives,124 senile hypertensives,46 presenile healthy controls and 63 senile healthy controls.The incidences of total atrial and ventricular arrhythmias were 90.2% and 59.8% in presenile hypertensives,98.4%and 75.0%in senile bypertensives respectively(all P<0.01).Their incidences in presenile healthy controls were 80.4%and 45.7%respectively,and the differences between them with those of the presenile hypertensives were not significant(all P>0.05).The incidences of total atrial and ventricular arrhythmias in senile healthy controls were 87.3% and 52.3%respectively,and the differences between them with those of the senile hypertensives were statistically significant(all P<0.01).In senile hypertensives with left ventricular hypertrophr(LVH,66 cases),the incidences of total ventricular arrhythmias and Lown's grade≥3 ventricular arrhythmias were 84.8% and 36.4% respectively.Their incidences in senile hypertensives without LVH(58 cases)were 63.8% and 13.8% respectively.There were significant differences between them(all P<0.01).In presenile hypertesive with LVH(42 cases),the incidence of Lown's grade≥3 ventricular arrhythmias was 19.0%,but the incidence of Lown's grade≥3ventricular arrhythmias was only 2.5%in presenile hypertensive without LVH.The difference was statistically significant(P<0.05).The results suggest that arrhythmias often occur in hypertensives and have an increased tendency in the seniles;in particular,ventricular arrhythmias seems closely related to LVH.

关 键 词：高血压 心律失常 左室肥厚 老年人 

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