阵发性心房颤动患者症状特性及倍他乐克的干预作用  

Clinical features of patients with paroxysmal atrial fibrillation and the effects of betaloc on symptoms

作　　者：毕亚艳[1] 刘雨舒[1] 朴晶艳[1] 黄永麟[1] 

机构地区：[1]哈尔滨医科大学附属第一临床医院心内六科,黑龙江哈尔滨150001

出　　处：《中国心脏起搏与心电生理杂志》2009年第6期499-501,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的分析阵发性心房颤动(简称房颤)患者症状发生的特性及倍他乐克的干预作用。方法经24 hHolter监测确诊的阵发性房颤患者50例,分析其症状的有无及发生比率。经倍他乐克治疗3个月后再次行Holter监测,分析房颤症状的变化情况。采用多元Logistic回归分析阵发性房颤症状的有无与临床特征的相关性。结果50例患者中26例(52%)为无症状房颤发作,24例为有症状房颤发作。经倍他乐克治疗后,24例有症状房颤患者中13例症状完全消失,其中10例为窦性心律,3例为无症状房颤;在26例无症状房颤患者中,9例仍有无症状房颤发作。房颤的症状与性别有关,女性更易产生症状(P<0.05),与左房内径呈负相关(P<0.01),与心室率及心率差值呈正相关(P<0.05)。结论阵发性房颤患者中无症状的发生率较高,倍他乐克既可减少房颤病人的症状,又可减少无症状房颤的发作。女性、心室率快、心率差值大者更易产生症状,左房内径大者不易产生症状。Objective To analyze the occurrence of symptoms in patients with paroxysmal atrial fibrillation （PAF） and the influence of Betaloc on it, and investigate the correlation between symptoms and clinical features. Methods Fifty patients who were conformed to have PAF by hoher monitoring were enrolled in our hospital. Calculating the ratio of the occurrence of asymptomatie AF. All of these patients were administrated with Betaloc for three months, and then Hoher monitoring were repeated to record the incidence of AF. Multivariate logistic regression was applied for analyzing the correlation between symptoms and clinical features. Results Twenty-six patients （52%） were asmptomatic, and 24 patients were symptomatic. After treatment, clinical symptoms were absent in 13 patients, of whom 10 were sinus rhythm, 3 were asymptomatic PAF. In the 26 cases of asymptomatic PAF, however, attacks of PAF were still present in 9 patients. The incidence of symptoms was higher in female（ P 〈0.05 ）. Symptoms were negatively correlated with left atrial diameter （P 〈0.01 ）, but were positively correlated with ventricular rate and AF-sinus （ P 〈 0.05 ）. Conclusions The incidence of asymptomatic PAF was in a high percentage. Betaloc could not only relieve the symptoms of AF patients, but also relieve the episodes of asymptomatic AF. The patients with fast heart rate, big difference of ventricular rate or female are subject to present symptom, but sympotom is not found in patients with large left atrial diameter.

关 键 词：心血管病学 阵发性心房颤动 症状 临床特征 无症状心房颤动 

分 类 号：R541.75[医药卫生—心血管疾病] R972.2[医药卫生—内科学]