三七总皂苷对肝纤维化大鼠肝脏超微结构的影响-第三军医大学学报.doc

PAGE 特发性室性早搏负荷及起源位置对左心功能的影响 曹中静，宋治远，舒茂琴，冉擘力，钟理，蒋周芩，邓盛荣，李华康(400038 重庆，第三军医大学：第一附属医院西南医院心内科） ［摘要］ 目的 探讨室性早搏（Premature ventricular contractions，PVCs）负荷和起源对左心功能的影响及其相关因素。 方法 对我中心在2012年4月至2013年3月收治的91例特发性PVCs患者按照下述方法分组。根据PVCs负荷将所有91例患者分为A1组（PVCs负荷6%~19%）和A2组（PVCs负荷20%~54%）；按导管消融术标测的PVCs起源部位将73例患者分为右室流出道B1、右室非流出道B2、左室流出道B3和左室非流出道B4四组。对各亚组左心结构与功能参数进行统计分析。结果 高负荷A2组的左房双期容积（LAVmax、LAVmin）、氮末端-脑利钠肽前体（NT-proBNP）显著高于低负荷A1组（P0.05）；PVCs负荷与左房双期容积以及NT-proBNP呈显著正相关（P0.05），PVCs负荷与左室射血分数（LVEF）呈显著负相关（P=0.03）；左室起源组较右室起源组有更大的左室/左房直径（左室舒张末期直径-LVEDD（51.7±6.3 mm对48.3±5.0 mm, P=0.024）以及左房最大直径-LADmax (36.2±4.4 mm对33.1±4.7 mm, P=0.012)，右室流出道B1组的LAVmax较右室非流出道B2更大（43.5±12.9 mm和32.7±8.4 mm，P=0.007），左室流出道B3组的左房直径最大LADmax（37.3±4.3 mm, P=0.006）。结论 PVCs负荷和/或起源部位影响左心功能，左房受到的影响可能发生更早。 ［关键词］ 特发性室性早搏；负荷；起源位置；左心功能 ［中图法分类号］ ［文献标志码］ A Effect of idiopathic premature ventricular contractions burden and origin on left cardiac function Cao Zhongjing, Song Zhiyuan, Shu Maoqin, Ran Boli, Zhong li, Jiang Zhouqin, Deng Shenrong, Li Huakang (Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China) [Abstract] Objective To explore the effect of idiopathic premature ventricular contractions (PVCs) burden and origin on left heart structure and function. Methods Ninety-one consecutive patients with idiopathic PVCs treated in our center between April 2012 and March 2013 were divided into group A1(6%～19%) and group A2(20%～54%) according to PVCs bruden. Seventy-three patients after catheter ablation were further divided into four groups according to PVC origin, including right ventricular outflow tract group B1, right ventricular non-outflow tract group B2, left ventricular outflow tract group B3 and left ventricular non-outflow tract group B4. The parameters of the structure and function of left cardiac in each subgroup were analyzed with statistical methods. Results The double phase volume of left atrium（LAVmax、LAVmin）and N-terminal pro