摘要
为探讨高血压左心室肥厚（ＨＬＶＨ）患者心肌缺血情况以及心肌缺血与室性心律失常的关系。对９３例超声确定的ＨＬＶＨ病人行动静态９９ｍＴｃ－ＭＩＢＩ心肌断层显像，２４小时动态心电图检查，其中６９例行运动心电图（ＥＥＣＧ）检查，８例行冠状动脉造影。年龄，性别相配的４９例单纯性高血压病（ＳＨＴ）病人作对照。结果：（１）ＨＬＶＨ患者有４１．９％病人伴心肌缺血，其中６４．１％为无症状性心肌缺血。（２）左室重量指数（ＬＶＭＩ）和年龄在单纯ＨＬＶＨ组（ＳＬＶＨ）与ＨＬＶＨ伴缺血组（ＬＶＨＩ）之间没有统计学上的差异，调整性别因素影响，两者仍无差异。（３）ＨＬＶＨ组复杂室性早搏（ＣＶＡ）发生率明显比ＳＨＴ组高，而ＳＬＶＨ组与ＳＨＴ组相比，ＣＶＡ发生率无差异，ＬＶＨＩ组ＣＶＡ发生率明显比ＳＬＶＨ组与ＳＨＴ组高。（４）ＬＶＨＩ组内ＣＶＡ发生与无ＣＶＡ两亚组间年龄和ＬＶＭＩ无显著差异。结论：ＨＬＶＨ患者心肌缺血发生率达４１．９％，而且大部分为无症状性心肌缺血；其ＣＶＡ发生率主要与心肌缺血存在及程度相关；
Weinvestigatedtheprevalenceofmyocardialischemiaandtherelationshipbetweenmyocardialischemiaandcomplexventriculararrhythmia(CVA)inpatientswithhypertensiveleftventricularhypertrophy(HLVH).99mTc-MIBImyocardialperfusionimagingatrestandduringexer-cise,and24-hourambulatoryelectrocardiographicmonitoringwereperformedin93patientswithHLVHdiagnosedbyechocardigraphy.69patientsweresubjectedtoexerciseECG(EECG)and8coronaryangiography.49patientswithsimplehypertension(SHT)matchedforageandsexascon-trol.OfthepatientswithHLVH,myocardialischemiawasdiagnosedon99mTc-MIBIscintigraphyin41.9%,amongwhich64.1%wereasymptomatic.Leftventricularmassindex(LVMI)andageweresimilarbetweensimpleLVH(SLVH)groupandLVHwithischemia(LVHI)group.Afteradjust-mentforsex,thesetwoparametersremainednotdiferent.TheincidenceofCVAinHLVHgroupwashigherthanthatintheSHTgroup,andnostatisticaldifferencewasfoundbetweenSHTgroupandSLVHgroup.LVHIgroupshowedsignificantlyhighepisodesofCVAthanSLVHandSHTgroups.InLVMIgroup,therewasnomarkeddiferenceinLVMIandagebetweensubgroupswithorwithoutCVA.InSLVHpatients,theoccurenceofmyocardialischemiawas41.9%,mostofwhichwasasymptomatic.TheincidenceofCVAwasrelatedtotheprevalenceandextentofmyocar-dialischemiaandthedegreeofLVHseemednottoplayanimportantroleintheoccurenceofmyocar-dialischemiaandCVAinHLVHpatients.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1996年第6期441-444,共4页
Chinese Journal of Cardiology
关键词
高血压
心肌缺血
心律失常
hypertensionhypertrophy,leftventricularmyocardialischemiaarhythmi
