高血压伴阵发性心房颤动患者触发性房性期前收缩的特征分析  

Features of triggering atrial premature contraction in patients with hypertension and paroxysmal atrial fibrillation

作　　者：杨中良[1,2] 张彩萍 王乃玲[1] 孙宝玲[1] 李剑[1] 刘卫东 

机构地区：[1]上海市浦东新区浦南医院心内科,200125 [2]上海市蓝十字医学科学研究所 [3]浙江省临海市第一人民医院心内科

出　　处：《中国心血管杂志》2012年第6期430-433,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的研究高血压伴阵发性心房颤动(PAf)患者触发性房性期前收缩(APC)的电生理特点。方法将46例高血压伴APC触发PAf患者(高血压组)的动态心电图进行人工回放,分析触发性APC的起源部位、联律间期(CI)及期前收缩指数(PI),并与35例非高血压伴PAf患者(非高血压组)对比分析。结果高血压组患者触发性APC主要来源于左心房上部(61.7%),与非高血压组(59.1%)相比差异无统计学意义(P=0.658)。高血压组触发性APC的CI及PI分别为(374.1±31.5)ms和0.50±0.05,均明显短(低)于非触发性APC[(443.6±32.6)ms和0.63±0.06,均为P=0.000],也短(低)于非高血压组[(395.7±38.2)ms和0.55±0.08,均为P=0.000]。高血压组APC前心动周期(PC)为(746.2±50.6)ms,显著长于非高血压组[(724.9±70.3)ms,P=0.004]。结论高血压伴PAf患者触发性APC主要起源于左心房上部,触发性APC的CI和PI明显短(低)于非高血压伴PAf患者。高血压患者出现CI较短或PI较低的APC时,应及时处理,防止PAf发生。Objective To explore the electrophysiological features of triggering atrial premature contraction （APC） in patients with hypertension and paroxysmal atrial fibrillation （PAl） and its clinical significance. Methods Artificial playback of dynamic electrocardiogram was performed for 46 cases with hypertension and APC-triggered PAf （ hypertension group） and 35 patients with non-hypertensive PAf （ non- hypertension group） from April 2008 to March 2011 in Shanghai Punan Hospital of Pudong New District. The originating sites, coupling interval （ CI ） and prematurity index （ PI ） of triggering APC were analyzed and compared between the two groups. Results Triggering APCs originated mainly in upper left atrium （61.7%） in hypertension group, and was similar to that in non-hypertension group （59. 1% , P =0. 658）. CI of triggering APC in hypertension group was significantly shorter [ （374. 1 ±31.5） ms vs. （443.6 ±32. 6） ms and （395.7 ±38. 2） ms, both P =0. 000] and PI of triggering APC was significantly lower （0. 50 ±0. 05 vs. 0. 63 ± 0. 06 and 0. 55 ± 0. 08, both P = 0. 000） than non-triggering APC in hypertension group and in non- hypertension group. The preceding cycle length （PC） was significantly longer in hypertension group than that in non-hypertensive group [ （ 746. 2 -± 50. 6 ） ms vs. （ 724. 9 ± 70. 3 ） ms, P = 0. 004 ] . Conclusions The triggering APC in hypertensive PAl patients mainly originates in left upper atrium. CI and PI of triggering APC are significantly shorter or lower than those in non-hypertensive PM patients.

关 键 词：高血压 阵发性心房颤动 触发性房性期前收缩 联律间期 期前收缩指数 

分 类 号：R541.7[医药卫生—心血管疾病]