CAJ | 학술논문

目的：比较心房颤动（AF）与窦性心律患者心房大小和组织结构的变化，探讨AF对心脏功能的影响及其临床意义。方法选取需行体外循环手术无心力衰竭临床表现的患者79例，其中，A F患者（A F组）39例，窦性心律患者（窦性组）40例。术前采用超声心动图检查测量其左室舒张末期内径（LVDd）、左室收缩末期内径（LVDs）、左心室后壁厚度（LVPW）、室间隔厚度（IVS）及左房的内径（LAD）的变化。术中取新鲜的左心耳组织，石蜡包埋切片，HE染色，观察心肌组织结构的变化。结果 AF组LVDd、LVDs、LVPW、IVS均低于窦性组，而AF组LAD明显大于窦性组，AF组与窦性组IVS和LAD的比较，差异有统计学意义（P＜0．05），其他指标差异无统计学意义（P＞0．05）。与窦性组相比，AF组心肌萎缩变细，纤维化明显，细胞核变小，HE染色变深。结论 AF的原发病中以风湿性心脏病最多见，同时AF的发生多伴有LAD的增大和心肌结构的变化，说明AF使心脏功能发生改变。
목적：비교심방전동（AF）여두성심률환자심방대소화조직결구적변화，탐토AF대심장공능적영향급기림상의의。방법선취수행체외순배수술무심력쇠갈림상표현적환자79례，기중，A F환자（A F조）39례，두성심률환자（두성조）40례。술전채용초성심동도검사측량기좌실서장말기내경（LVDd）、좌실수축말기내경（LVDs）、좌심실후벽후도（LVPW）、실간격후도（IVS）급좌방적내경（LAD）적변화。술중취신선적좌심이조직，석사포매절편，HE염색，관찰심기조직결구적변화。결과 AF조LVDd、LVDs、LVPW、IVS균저우두성조，이AF조LAD명현대우두성조，AF조여두성조IVS화LAD적비교，차이유통계학의의（P＜0．05），기타지표차이무통계학의의（P＞0．05）。여두성조상비，AF조심기위축변세，섬유화명현，세포핵변소，HE염색변심。결론 AF적원발병중이풍습성심장병최다견，동시AF적발생다반유LAD적증대화심기결구적변화，설명AF사심장공능발생개변。
Objective To compare the differences of atria and atrial myocyte structure in patients with atrial fibrillation (AF) and sinus rhythm(SR) .To evaluate the influence of AF on cardiac function .Methods 79 patients without heart failure undergoing car-diopulmonary bypass surgery were divided into the AF group (n=39) and the SR group(n=40) .Echocardiography was performed for analysis of left ventricular end diastolic dimension(LVDd) ,left ventricular end-systolic dimension(LVDs) ,left ventricular poste-rior wall(LVPW) ,interventricular septum(IVS) and left atrial diameter(LAD) .Part of left atrial appendages was taken freshly for HE staining in order to observe atrial tissue structure .Results LVDd ,LVDs ,LVPW and IVS of the AF group were lower than that of the SR group .But LAD of the AF group was higher than the SR group .There was statistical significance in IVS and LAD between the two groups(P<0 .05) ,and there were no significant differences in other aspects (P>0 .05) .Compared with the SR group ,the AF group had thinner myocardial atrophy ,more obvious fibrosis ,smaller nucleus and darker HE staining .Conclusion The incidence of AF was mainly in rheumatic heart disease .The development of AF was mostly accompanied with the enlargement of LAD and the change of atrial tissue structure which showed that AF can reduce cardiac function .