高血压左心室肥厚患者的心肌缺血和室性心律失常  

Myocardialischemiaandventriculararrhythmiainhypertensivepatientswithleftventricularhyper┐trophy

作　　者：陈松苍[1] 吴可贵[1] 陈达光[1] 林好学[1] 赖鹏斌 苏津自 林明[1] 王华军[1] 

机构地区：[1]福建医学院附属第一医院

出　　处：《中华心血管病杂志》1996年第6期441-444,共4页Chinese Journal of Cardiology

摘　　要：为探讨高血压左心室肥厚（ＨＬＶＨ）患者心肌缺血情况以及心肌缺血与室性心律失常的关系。对９３例超声确定的ＨＬＶＨ病人行动静态９９ｍＴｃ－ＭＩＢＩ心肌断层显像，２４小时动态心电图检查，其中６９例行运动心电图（ＥＥＣＧ）检查，８例行冠状动脉造影。年龄，性别相配的４９例单纯性高血压病（ＳＨＴ）病人作对照。结果：（１）ＨＬＶＨ患者有４１．９％病人伴心肌缺血，其中６４．１％为无症状性心肌缺血。（２）左室重量指数（ＬＶＭＩ）和年龄在单纯ＨＬＶＨ组（ＳＬＶＨ）与ＨＬＶＨ伴缺血组（ＬＶＨＩ）之间没有统计学上的差异，调整性别因素影响，两者仍无差异。（３）ＨＬＶＨ组复杂室性早搏（ＣＶＡ）发生率明显比ＳＨＴ组高，而ＳＬＶＨ组与ＳＨＴ组相比，ＣＶＡ发生率无差异，ＬＶＨＩ组ＣＶＡ发生率明显比ＳＬＶＨ组与ＳＨＴ组高。（４）ＬＶＨＩ组内ＣＶＡ发生与无ＣＶＡ两亚组间年龄和ＬＶＭＩ无显著差异。结论：ＨＬＶＨ患者心肌缺血发生率达４１．９％，而且大部分为无症状性心肌缺血；其ＣＶＡ发生率主要与心肌缺血存在及程度相关；Weinvestigatedtheprevalenceofmyocardialischemiaandtherelationshipbetweenmyocardialischemiaandcomplexventriculararrhythmia(CVA)inpatientswithhypertensiveleftventricularhypertrophy(HLVH).99mTc-MIBImyocardialperfusionimagingatrestandduringexer-cise,and24-hourambulatoryelectrocardiographicmonitoringwereperformedin93patientswithHLVHdiagnosedbyechocardigraphy.69patientsweresubjectedtoexerciseECG(EECG)and8coronaryangiography.49patientswithsimplehypertension(SHT)matchedforageandsexascon-trol.OfthepatientswithHLVH,myocardialischemiawasdiagnosedon99mTc-MIBIscintigraphyin41.9%,amongwhich64.1%wereasymptomatic.Leftventricularmassindex(LVMI)andageweresimilarbetweensimpleLVH(SLVH)groupandLVHwithischemia(LVHI)group.Afteradjust-mentforsex,thesetwoparametersremainednotdiferent.TheincidenceofCVAinHLVHgroupwashigherthanthatintheSHTgroup,andnostatisticaldifferencewasfoundbetweenSHTgroupandSLVHgroup.LVHIgroupshowedsignificantlyhighepisodesofCVAthanSLVHandSHTgroups.InLVMIgroup,therewasnomarkeddiferenceinLVMIandagebetweensubgroupswithorwithoutCVA.InSLVHpatients,theoccurenceofmyocardialischemiawas41.9%,mostofwhichwasasymptomatic.TheincidenceofCVAwasrelatedtotheprevalenceandextentofmyocar-dialischemiaandthedegreeofLVHseemednottoplayanimportantroleintheoccurenceofmyocar-dialischemiaandCVAinHLVHpatients.

关 键 词：高血压 心肌缺血 心律失常 

分 类 号：R544.106[医药卫生—心血管疾病] R541.4[医药卫生—内科学]