心房颤动患者“曲尺”状Lorenz散点图的临床意义  

Clinical significance of square-shaped Lorenz plot in patients with atrial fibrillation

作　　者：李彦[1] 包明威[1] 向晋涛[1] 黄从新[1] 

机构地区：[1]武汉大学人民医院心内科,430060

出　　处：《中华心律失常学杂志》2014年第2期119-122,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：国家科技支撑计划

摘　　要：目的：分析心房颤动（房颤）患者Lorenz散点图的特点，并探讨“曲尺”状Lorenz散点图的临床意义。方法从2012年1月至2013年7月于武汉大学人民医院确诊的房颤患者中，按照一定的标准选取220例，行体表心电图、24 h动态心电图、超声心动图检查，检测长RR间期个数、24 h平均心率、各心腔内径、左心室射血分数（ LVEF）等指标。结果 Lorenz散点图“曲尺”状图形表现为散点图的扇形圆边缘被一“曲尺”状图形覆盖，边界清晰。根据有无“曲尺”状图形，将入选的220例病例分为A组（n=40）、B组（n=180）。两组病例中RR间期〈1．5 s个数、最慢心率、最快心率、24 h平均心率、左右心房及右心室内径、左心室射血分数均差异有统计学意义（P〈0．05）；年龄、RR间期〈2．0 s个数、主动脉内径、左心室内径、室间隔及左心室后壁厚度差异无统计学意义（ P〉0．05）。结论房颤患者Lorenz散点图中“曲尺”状图形与平均心率下降、左心房内径增大、LVEF减低相关，提示心房存在明显结构重构和电重构。Objective To analyse the characteristics of Lorenz plot in patients with atrial fibrillation and to investigate the clinical significance of square-shaped Lorenz plot. Methods Two-hundred and twenty patients with atrial fibrillation were enrolled in this study from January 2012 to July 2013. The data of electro-cardiogram, 24 h dynamic electrocardiogram and echocardiography were collected including the number of long RR interval, 24 h average heart rate, atrial and ventricular dimension and left ventricular ejection fraction. Re-sults The square-shaped Lorenz plot had a fan-shaped rounded edge with a “square” patterned cover and a clear boundary. Based on the Lorenz plot with or without “square”, 220 cases were divided into group A（ n=40） and group B（n=180）. The number of long RR interval（〈 1. 5 s）,the fastest heart rate, the slowest heart rate, average heart rate, left and right atrioventricular dimension, left ventricular ejection fraction, were statis-tically different （ P〈0. 05 ） between the two gtoups. There were no statistical difference among the mean age, number of long RR interval（〉2. 0 s） , aorta and left ventricle dimension,the thickness of interventricular sep-tum and left ventricular posterior wall （P〉0. 05）. Conclusion The square-shaped Lorenz plot in patients with atrial fibrillation was related to average heart rate decreasing, left atrial dimension increasing and left ventricular ejection fraction decreasing, suggesting that atrium has obvious structure and electrical remodeling, and atrial fibrillation is easily occurred and maintained.

关 键 词：LORENZ散点图 心房颤动 

分 类 号：R540.41[医药卫生—心血管疾病] R541.75[医药卫生—内科学]