早搏性心律失常的多重危险因素及病理特征临床研究

发布时间：2018-06-14 08:38

本文选题：心律失常 + 危险因素　；参考：《中华中医药学刊》2017年01期

【摘要】：目的:探讨心律失常的高危因素、中医证候特点和物理检查特征表现。方法:将北京中医药大学国医堂门诊随诊164例心律失常患者和随机抽查的164例病人分为观察组和对照组,通过化验血糖、血脂,检查血压值、超声心动检查左室收缩内径、左室舒张内径的宽度和室间隔厚、左室后壁的厚度、射血分数;24 h动态心电图的SDNN、SDANN和RMSSD;心电图检查测量P波离散度、QT离散度,两组结果通过SPSS 17.0软件包进行统计分析。同时记录本病中医常见证候频次频率。结果:164例心律失常患者高脂血症患者71例(43.29%),高血压病74例(45.12%),糖尿病67例(40.85%),3种危险因素在观察组中的发生率要高于正常组人员(P0.01)。中医常见证候类型出现频率由高到低为:心脾两虚证42例(25.61%)、心虚胆怯证33例(20.12%)、阴虚火旺证28例(17.07%)、心血瘀阻证24例(14.63%)、痰热扰心证15例(9.15%)、心肾阳虚证13(7.92%)、气虚证9例(5.49%)。超声心动检查观察组的左室收缩内径、左室舒张内径的宽度和室间隔厚、左室后壁的厚度均高于对照组人员(P0.05)观察组射血分数要低于正常组人员(P0.05)。24 h动态心电图检查观察组中SDNN低于对照组(P0.05),而SDANN和RMSSD在观察组中要高于对照组(P0.05或0.01)。心电图检查测量观察组P波离散度、QT离散度要高于对照组人员(P0.05或0.01)。结论:高血压、高血脂、高血糖是心律失常发病的危险因素,结合中医病机特点,解释了中医理论"久病伤络"在心律失常发病机制的含义和物理检查对本病的诊断和预后的指导。
[Abstract]:Objective: to investigate the high-risk factors of arrhythmia, the characteristics of TCM syndromes and physical examination. Methods: 164 patients with arrhythmia and 164 randomly selected patients were divided into observation group and control group. Blood pressure and left ventricular systolic diameter were examined by blood glucose, blood lipid, blood pressure and echocardiography. The width of left ventricular diastolic diameter, the thickness of left ventricular septum, the thickness of left ventricular posterior wall, the SDNN SDANN and RMSSDof 24 h ambulatory electrocardiogram of ejection fraction, the P wave dispersion and QT dispersion were measured by electrocardiogram, and the results of the two groups were analyzed by SPSS 17.0 software package. At the same time, the frequency of common syndromes of TCM was recorded. Results there were 71 cases with hyperlipidemia in 1: 164 patients with arrhythmia, 71 with hyperlipidemia, 74 with hypertension and 45.125.67 with diabetes mellitus. The incidence of three risk factors in the observation group was higher than that in the normal control group (P 0.01). The frequency of common syndromes in TCM was from high to low: 42 cases with deficiency of heart and spleen, 33 cases with heart asthenia and timidity, 28 cases with Yin deficiency and fire, 24 cases with heart blood stasis, 15 cases with 9. 1515, 13 cases with deficiency of heart and kidney yang, 9 cases with Qi deficiency, 9 cases with Qi deficiency and 9 cases with 5. 490.The frequency of occurrence of common syndromes in traditional Chinese medicine was from high to low: 42 cases with deficiency of heart and spleen, 33 cases with heart deficiency and timidity, 28 cases with syndrome of deficiency of yin and fire, 24 cases with syndrome of heart blood stasis and obstruction of heart and blood. Left ventricular systolic diameter, left ventricular diastolic diameter and ventricular septal thickness were measured by echocardiography. The thickness of left ventricular posterior wall was higher than that of control group (P0.05) the ejection fraction in observation group was lower than that in control group (P 0.05). The SDNN in observation group was lower than that in control group, while SDANN and RMSSD in observation group were higher than those in control group (P 0.05 or 0.01). The P wave dispersion and QT dispersion in the observation group were higher than those in the control group (P0.05 or 0.01). Conclusion: hypertension, hyperlipidemia and hyperglycemia are the risk factors of arrhythmia. This paper explains the meaning of TCM theory of "long illness and collateral injury" in the pathogenesis of arrhythmia and the guidance of physical examination to the diagnosis and prognosis of this disease.
【作者单位】：北京中医药大学基础医学院;PLA
【基金】：国家自然科学基金项目(81173142)
【分类号】：R259

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