阵发性房颤的左室重构和心率变异性与血瘀证相关的临床研究

发布时间：2018-06-05 02:08

  本文选题：阵发性房颤 + 血瘀证　； 参考：《福建中医药大学》2017年硕士论文

【摘要】：目的:通过研究阵发性房颤患者的左室重构与血瘀证及心率变异性与血瘀证的关系,为阵发性房颤的临床预防和治疗提供新的思路。研究方法:收录2016年1月至2017年1月时间段内,就诊于福建中医药大学附属第二人民医院门诊或病房的、符合阵发性房颤诊断标准的患者的资料。根据中医四诊辨证论治,对入选的阵发性房颤患者进行血瘀证的辨证分析,最终将入选者分为血瘀证组(40例)、非血瘀证组(20例),并同时收录福建中医药大学附属第二人民医院健康体检者20例,作为正常对照组;再根据血瘀证积分情况,将血瘀证组内入选者分为积分≥10分组和积分10分组。检测所入选者的血瘀证信息和心脏彩超相关指数(舒张期末期室间隔厚度(IVST)、舒张期末期左室后壁厚度(LVPWT)、左心室舒张末内径(LVEDD)、左心室质量指数(LVMI))及动态心电图中心率变异性(HRV)各指数(RR间期标准差(SDNN)、均值标准差(SDANN)、相邻RR间期均方差(RMSSD)、低间期差值大于50ms所占百分比(PNN50)),运用SPSS20对数据进行分析。结果:1.血瘀证组的IVST、LVPWT、LVEDD、LVMI的数值较对照组明显增高,差异具有统计学意义(P0.05);血瘀证组的IVST、LVMI的数值较非血瘀证组明显增高,差异具有统计学意义(P0.05);非血瘀证组的LVPWT较对照组明显增高,差异具有统计学意义(P0.05)。2.血瘀证组的SDNN、SDANN、RMSSD、PNN50的数值较对照组明显增高,差异具有统计学意义(P0.05);血瘀证组的SDNN、SDANN、RMSSD、PNN50的数值较非血瘀证组明显增高,差异具有统计学意义(P0.05);非血瘀证组的RMSSD较对照组数值明显增高,差异具有统计学意义(P0.05)。3.积分≥10分组的IVST、LVPWT、LVEDD、LVMI的数值较对照组明显增高,差异具有统计学意义(P0.05);积分≥10分组的LVEDD、LVMI的数值较积分10分组明显增高,差异具有统计学意义(P0.05);积分10分组的LVPWT较对照组数值明显增高,差异具有统计学意义(P0.05)。4.积分≥10分组的SDNN、SDANN、RMSSD、PNN50的数值较对照组明显增高,差异具有统计学意义(P0.05);积分≥10分组较积分10分组的数值差异无统计学意义(P0.05);积分10分组的SDNN、SDANN、PNN50较对照组数值明显增高,差异具有统计学意义(P0.05)。结论:1.PAF患者存在左室重构,且血瘀证较非血瘀证严重。2.PAF患者心率变异性增高,且血瘀证较非血瘀证严重。3.PAF患者左室重构程度随血瘀证积分的增高而加重。4.血瘀证组较非血瘀证组IVST、LVMI、SDNN、SDANN、RMSSD、PNN50等有明显增高。因此,血瘀可能参与心脏组织重构,引起左室重构,使心室的解剖结构变化,且随着血瘀程度增加而加重;同时影响自主神经对于心脏的调节,从而导致PAF的发生和发展。
[Abstract]:Objective: to study the relationship between left ventricular remodeling and blood stasis syndrome, heart rate variability and blood stasis syndrome in patients with paroxysmal atrial fibrillation, so as to provide new ideas for clinical prevention and treatment of paroxysmal atrial fibrillation. Methods: the data of patients who met the diagnostic criteria of paroxysmal atrial fibrillation were collected from January 2016 to January 2017 in the outpatient or ward of the second people's Hospital affiliated to Fujian University of traditional Chinese Medicine. According to the four diagnosis and treatment of TCM, the selected patients with paroxysmal atrial fibrillation were analyzed based on the syndrome differentiation of blood stasis. Finally, the selected patients were divided into blood stasis syndrome group (n = 40) and non-blood stasis syndrome group (n = 20). At the same time, 20 healthy persons in the second people's Hospital affiliated to Fujian University of traditional Chinese Medicine were included as normal control group, and then according to the score of blood stasis syndrome, The selected patients in blood stasis group were divided into integral 鈮，

本文编号：1979949