高血压病患者心房颤动与动脉粥样硬化的相关性  

Association of Atrial Fibrillation and Atherosclerosis in Patients with Hypertension

作　　者：孙伏清[1] 陈平[1] 周晓兰[1] 陈启光[1] 游学文[1] 林晨曦[2] 林星[1] 

机构地区：[1]福建省福清市医院心血管内科,福建省福清市350300 [2]福建省福清市医院心脏超声科,福建省福清市350300

出　　处：《中国动脉硬化杂志》2011年第12期1015-1019,共5页Chinese Journal of Arteriosclerosis

基　　金：2009年福清市科技计划项目

摘　　要：目的分析高血压病患者心房颤动与动脉粥样硬化的相关性。方法本研究共纳入高血压病患者145例,根据心电图表现分为两组:其中窦性心律组75例、心房颤动组70例。分析145例高血压病患者的一般临床资料,同时使用颈动脉彩超测定颈动脉内膜中膜厚度及粥样斑块个数,从而判断高血压患者的动脉硬化程度。结果高血压病合并心房颤动患者组颈动脉内膜中膜厚度明显高于窦性心律组(P<0.05),其斑块检出率(53.5%)明显高于窦性心律组(19.0%;P<0.01)。颈动脉内膜中膜厚度及粥样斑块检出率与年龄、高血压病程、高敏C反应蛋白等成正相关(P<0.05)。多元Logistic回归分析显示,校正主要的危险因素后,心房颤动是颈动脉粥样斑块的相关危险因素(OR值为1.752,P<0.01)。结论在排除了年龄、高血压病程、收缩压、高敏C反应蛋白等可导致颈动脉内膜中膜厚度增厚及粥样斑块形成等干扰因素后,心房颤动可能是导致颈动脉内膜中膜厚度增厚及粥样斑块形成的一个相关危险因素。Aim To investigate the relationship between atrial fibrillation（AF） and atherosclerosis in patients with hypertension. Methods 145 subjects were enrolled in the present study,according to the results of electrocardiogram,and were divided into two groups： 75 subjects with sinus rhythm and 70 subjects with AF.The baseline clinical characteristics of the patients were analyzed and the intima-media thickness（IMT） and the prevalence atherosclerosis plaques of the carotid artery were measured by echocardiography. Results Individuals with AF had higher carotid artery IMT（P0.05）and the increased prevalence atherosclerosis plaques（P0.01） than those with sinus rhythm（P0.05）.Age,the presence of AF,the course of hypertension,and hs-CRP were found to be significantly correlated with carotid artery IMT and the prevalence atherosclerosis plaques.Multivariate logistic regression revealed that AF was independently associated with the presence of carotid prevalence atherosclerosis plaques（OR=1.752,P0.01） after adjusting for other confounded factors. Conclusions The presence of atrial fibrillation was significantly correlated with carotid artery IMT and the prevalence atherosclerosis plaques after adjusting for age,the course of hypertension,and hs-CRP in patients with hypertension.

关 键 词：高血压 心房颤动 颈动脉内膜中膜厚度 动脉粥样硬化 

分 类 号：R5[医药卫生—内科学]