老年退行性瓣膜病并发心房纤颤患者心房结构特点分析  

Analysis of features ofatrial structur in patients with atrial fibrillation secondseniledegenerative valvular heart disease

作　　者：叶岗 罗文利[1] 柳达[1] 潘军强[2] 

机构地区：[1]石河子大学医学院第一附属医院老年病科,石河子832008 [2]陕西省人民医院心血管内二科,西安710068

出　　处：《陕西医学杂志》2018年第1期47-49,63,共3页Shaanxi Medical Journal

基　　金：陕西省自然科学基金资助项目(S2017-ZRJJ-1848)

摘　　要：目的:探讨老年退行性瓣膜病并心房纤颤患者心房结构特点。方法:入选心脏外科因老年退行性瓣膜病住院并行瓣膜置换手术的患者32例(房颤组16例、窦性心率组16例)。收集、整理入选患者临床资料,于术中取右心房组织标本,采用Masson染色观察心肌纤维化程度。结果:Masson染色结果提示:AF患者心房组织叫SR组患者存在明显纤维化。AF组心房组织CVF显著高于SR组,组间比较有统计学差异(t=12.36,P<0.05),心房组织CVF与右心房内径呈正相关(r=0.322,P<0.05)。结论:老年退行性瓣膜病并发心房纤颤患者心房组织存在明显纤维化,心房纤维化可能参与了老年退行性瓣膜病并发心房纤颤患者心房纤颤发生与维持。Objective:To summarize the features of atrial structure in patients with atrial fibrillation second senile degenerative valvular heart disease.Methods:32 consecutive patients with senile degenerative valvular heart disease who were going to undertake cardiac surgery were enrolled in this study.The patients were divided into two groups:the atrial fibrillation group(AF,n=16)and the sinus rhythm group(SR,n=16).Clinical datas including baseline demographics,routine laboratory testing and echocardiographics were available for all patients before the surgery.The right atrial tissue was disserted during the surgery.Right atrial fibrosis was observed by HE staining and Masson staining.Results:There were no significant difference in sex ratio,age,blood pressure,blood biochemical indicators and other aspects of medical history between two groups(P>0.05);left and right atrium diameters in AF group were significantly larger than that in the SR group(P<0.05).HE and Masson staining results suggest that the atrial tissue fibrosis was obvious,and collagen volume fraction was significantly higher in AF group compared to SR group(P<0.05).The collagen volume fraction from right atrial tissue in 32 patients were positively correlated with the right atrium diameters(r=0.322,P<0.05).Conclusion:There was significant atrial fibrosis in patients with atrial fibrillation second senile degenerative valvular heart disease;atrial fibrosis may be closely related to development atrial fibrillation.

关 键 词：心脏瓣膜疾病/并发症 心房颤动/病因学 心房颤动/诊断 老年人 ＠退行性瓣膜病 ＠心房结构重构 ＠心肌纤维化 

分 类 号：R541.7[医药卫生—心血管疾病]