风湿性心脏病并发心房颤动的临床因素比较.docVIP

风湿性心脏病并发心房颤动的临床因素比较 作者：段翔鹰,李莉 作者单位：中国人民解放军第85医院胸外科,上海 200052 【摘要】 目的 了解风湿性心脏病（风心病）并发心房颤动（房颤）与临床相关因素的关系。方法 将295例风湿性二尖瓣狭窄病人根据有无持续性房颤分为房颤组（AF组，n=212）和窦律组（SR组，n=83），术前均行常规心脏彩色多普勒超声检查。结果 AF组病人风心病病程及年龄明显高于SR组，左房直径、右房容积、右室容积均大于SR组，心功能等级较SR组差，三尖瓣反流量明显高于SR组，二尖瓣口面积小于SR组，中心静脉压和肺动脉楔压均明显高于SR组，差异均有显著意义（t′=3.270～20.272,P0.05）；两组之间的左室容积没有明显的差异。结论 风心病病人病程、年龄、左房直径、右房容积、心功能等级、三尖瓣反流量、二尖瓣反流量、二尖瓣口面积、中心静脉压、肺动脉楔压均可能与风心病房颤的发生存在联系。 【关键词】 风湿性心脏病 心房颤动 因素分析 统计学 COMPARISON OF CINICAL FACTORS IN PATIENTS WITH RHEUMATIC HEART DISEASEDUAN XIANGYING, LI LI(Department of Thoracic Surgery, The 85th Hospital of PLA, Shanghai 200052, China) ［ABSTRACT］ObjectiveTo study the relationships between clinical factors and sustained atrial fibrillation (AF) in rheumatic heart disease (RHD).MethodsTwohundred and ninetyfive RHD patients with mitral stenosis(MS) were divided into two groups: AF group (n=212) and sinus rhythm (SR)group (n=83), based on the presence or absence of sustained AF. Colour doppler ultrasonic examinations were performed before operations.ResultsPatients in AF group had longer courses of RHD and were older than patients in SR group. Furthermore, the LAD, RAV, RVV and TR of patients in AF group were larger than those of patients in SR group. The NYHA of AF patients were poorer than that of SR patients. CVP and PAWP in SR group were lower than that in AF group. All these differences were statistically significant. However, there was no significant difference of LVV between the two groups.ConclusionThere were significant differences in clinical factors between AF group and SR group, which might have some impact on the occurrence of AF in RHD MS patients. ［KEY WORDS］rheumatic heart disease; atrial fibrillation; factor analysis, statistical 心房颤动（房颤）是临床上最常见的持续性心律失常，风湿性二尖瓣狭窄是导致房颤的一个重要的原因。为了解房颤的发生与临床因素的关系，本文对295例风湿性心脏病（风心病）二尖瓣狭窄病人的临床因素进行对比研究。 1 资料与方法 1.1 一般资料 风心病二尖瓣狭窄病人295例，根据有无持续性房颤分为两组。并发持续性房颤组（AF组，房颤史1年）212例，男98例，女114例；年龄21～69