风心病单纯二尖瓣狭窄与合并心房颤动患者左心房压力变化的观察  

Investigation of change of left atrial pressure in patients with pure rheumatic mitral stenosis

作　　者：吴玉付[1] 李醒三[2] 

机构地区：[1]广西医科大学附属第四医院心内科,广西柳州545005 [2]广西医科大学附属第一医院心内科,广西南宁530021

出　　处：《重庆医学》2010年第1期69-70,共2页Chongqing medicine

摘　　要：目的探讨风湿性心脏病(风心病)单纯二尖瓣狭窄(rheumatic pure mitral stenosis,RMS)左心房压力变化。方法回顾分析242例RMS成功行经皮二尖瓣球囊扩张术(PBMV)患者资料,按有无心房颤动分为窦性心律组(122例)与心房颤动组(120例),分别对两组病程、心功能状态、左心房内径、瓣口面积、左心房最大压力、左心房最小压力、左心房平均压进行统计分析。结果两组二尖瓣口面积差异无统计学意义(P>0.05),心房颤动组年龄大于窦性心律组,差异有统计学意义(P<0.01),病程明显长于窦性心律组,差异有统计学意义(P<0.05),心功能亦明显差于窦性心律组,差异有统计学意义(P<0.01),心房颤动组左心房内径较窦性心律组明显增大,差异有统计学意义(P<0.01),心房颤动组左心房最大压力、左心房最小压力、左心房平均压均低于窦性心律组,差异有统计学意义(P<0.05)。结论单纯二尖瓣狭窄患者发生心房颤动后左心房压力下降,左心房内径进一步扩大可能是主要原因。Objective To study the change of left atrial pressure in the patients with pure rheumatic mitral stenosis. Methods The clinical data of 242 patients with rheumatic pure mitral stenosis performed percutaneous balloon mitral valvuloplasty（PBMV） successfully were analyzed retrospectively,the cases were divided into sinus rhythm group（122 cases） and atrial fibrillation group （120 cases） according to atrial fibrillation. These data were analysed statistically with SPSS15.0 For Windows. Results The mitral valve area was similar in the patients with sinus rhythm and with atrial fibrillation （（0.96±0.25）cm2 vs （0.92±0.22） cm2 ,P〈 0. 051. Patients with atrial fibrillation were older （（43.73± 10.50）years vs （38.34± 10.82）years,P〈0. 011 and had longer symptomatic period （130.78 vs 112.37 mean rank,years,P〈C0.05） and worse NYHA cardiac function（P〈0.01）and larger left atrial diameter （（55. 25± 7. 08） mm vs （49. 16±5. 72）mm,P〈0. 01） compared with those with sinus rhythm. Compared with sinus rhythm group,the patients of atrial fibrillation group had lower left pressure （P〈0.05）. Conclusion I.eft atrial pressure will de cline after atrial fibrillation occurrs in the patients with pure rheumatic mitral stenosls,lt may be main factor that left atrial become greater enlargement.

关 键 词：二尖瓣狭窄 左心房压力 风湿性心脏病 心房颤动 

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