老年高血压合并不同类型心房颤动患者心脏结构变化及其相关因素分析  

Cardiac structure change and its relevant factors in elderly hypertension patients with different types of AF

作　　者：孙婷婷[1] 陈梦宇[1] 吴大鹏 张红岩[1] Sun Tingting;Chen Mengyu;Wu Dapeng;Zhang Hongyan(Department of Cardiology,Second Affiliated Hospital of Qiqihar Medical College,Qiqihar 161000,Heilongjiang Province,China)

机构地区：[1]齐齐哈尔医学院附属第二医院心内科,161000

出　　处：《中华老年心脑血管病杂志》2021年第8期803-806,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：齐齐哈尔市科学技术计划项目(SFGG-201944)。

摘　　要：目的观察老年高血压合并不同类型心房颤动(房颤)患者心脏结构变化及其相关因素。方法选择2018年1月~2020年6月齐齐哈尔医学院附属第二医院心内科住院的高血压合并房颤患者87例,其中阵发性房颤患者45例(阵发性房颤组),持续性房颤患者42例(持续性房颤组),另选择同期就诊的单纯性高血压患者40例(对照组)。记录各组患者基本临床资料,进行实验室及超声心动图数据测量,包括B型钠尿肽、C反应蛋白、同型半胱氨酸、左心房内径等指标,并进行相关性分析。结果阵发性房颤组和持续房颤组B型钠尿肽、C反应蛋白、同型半胱氨酸水平明显高于对照组,且持续性房颤组B型钠尿肽、C反应蛋白、同型半胱氨酸水平明显高于阵发性房颤组[(272.95±26.21)ng/L vs(225.48±53.78)ng/L,P<0.05;(5.74±1.46)mg/L vs(4.89±1.17)mg/L,P<0.05;(16.93±3.33)μmol/L vs(15.05±3.97)μmol/L,P<0.05]。阵发性房颤组和持续性房颤组左心房内径明显高于对照组,LVEF明显低于对照组;持续性房颤组左心房内径明显高于阵发性房颤组[(41.9±2.4)mm vs(40.4±2.0)mm,P<0.05],LVEF明显低于阵发性房颤组[(55.1±4.5)%vs(57.7±5.9)%,P<0.05]。相关性分析显示,高血压合并持续性房颤患者B型钠尿肽、C反应蛋白、同型半胱氨酸水平与左心房内径呈正相关(r=0.825,r=0.884,r=0.832,P<0.01)。结论老年高血压合并房颤发作与B型钠尿肽、C反应蛋白、同型半胱氨酸水平升高密切相关,并随着房颤持续而加重,预防心肌重构可能降低房颤的发病风险。Objective To study the cardiac structure change and its relevant factors in elderly hypertension patients with different types of AF.Methods Eighty-seven hypertension patients with AF admitted to our hospital from January 2018 to June 2020 were divided into paroxysmal AF group(n=45)and persistent AF group(n=42)with 40 simple hypertension patients who visited our hospital during the same period served as a control group.Their baseline clinical data,laboratory testing and echocardiographic parameters were recorded.The relationship between cardiac structure change and its relevant factors was analyzed.Results The serum levels of BNP,CRP,and Hcy were significantly higher in paroxysmal AF group and persistent AF group than in control group,and in persistent AF group than in paroxysmal AF group(272.95±26.21 ng/L vs 225.48±53.78 ng/L,P<0.05;5.74±1.46 mg/L vs 4.89±1.17 mg/L,P<0.05;16.93±3.33μmol/L vs 15.05±3.97μmol/L,P<0.05).The left atrial diameter(LAD)was significantly longer while the LVEF was significantly lower in paroxysmal AF group and persistent AF group than in control group(P<0.05).The LAD was significantly longer while the LVEF was significantly lower in persistent AF group than in paroxysmal AF group(41.9±2.4 mm vs 40.4±2.0 mm,P<0.05;55.1%±4.5%vs 57.7%±5.9%,P<0.05).Correlation analysis showed that the serum levels of BNP,CRP and Hcy were positively related with the LAD in hypertension patients with persistent AF(r=0.825,r=0.884,r=0.832,P<0.01).Conclusion Hypertension with AF in the elderly is closely related with the elevated serum levels of BNP,CRP,Hcy and aggravates with persistent AF.Prevention of myocardial remodeling can reduce the risk of AF.

关 键 词：高血压 心房颤动 超声心动描记术 C反应蛋白质 高半胱氨酸 

分 类 号：R541.75[医药卫生—心血管疾病] R544.1[医药卫生—内科学]