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目的探讨老年人心房颤动(房颤)与冠心病的关系。方法根据我院1990年以来的尸检资料,选择年龄70岁以上,生前有房颤发作记录的69例男性患者为房颤组,临床均诊断有冠心病,其中慢性房颤32例。阵发性房颤37例；选择与房颤组年龄匹配、临床无房颤发作的60例男性患者作为对照组。比较房颤组与对照组以及房颤组中两种不同类型房颤亚组的冠状动脉病理结果。结果房颤组与对照组经病理证实的冠心病发病率为55．1%和53．3%,心肌梗死发生率为42．0%和35．0%,两组比较差异无统计学意义(P＞0．05)；两组患者主要冠状动脉的病变血管数量、病变程度和分布相似(P＞0．05)；房颤组与对照组心脏重量、左室壁厚度分别为[(440．5±81．9)、(398．7±82．2)g,P＜0．01；(1．42±0．34)、(1．27±0．32)cm,P＜0．05]。阵发房颤组除Ⅳ级病变的血管数量17支与对照组5支比较,差异有统计学意义(P＜0．05),其余各项指标与对照组比较,差异均无统计学意义(P＞0．05)。结论冠心病在老年患者中发病率较高,但与房颤没有明确的因果关系。
Objective To investigate the relationship between atrial fibrillation and coronary heart disease in the elderly. Methods According to the autopsy data of our hospital since 1990, 69 male patients aged 70 years and older who had atrial fibrillation records during their lifetime were selected as the atrial fibrillation group. There were 32 cases of CHD diagnosed clinically. Paroxysmal atrial fibrillation in 37 cases; choice and AF group age-matched, clinical onset of atrial fibrillation in 60 cases of male patients as a control group. Coronary artery pathology was compared between two different types of atrial fibrillation subgroups in the AF group and the control group and in the atrial fibrillation group. Results The incidences of pathologically confirmed coronary heart disease were 55.1% and 53.3% in AF group and those in control group were 42.0% and 35.0%, respectively. There was no significant difference between the two groups (P> 0.05). The number of coronary vessels and the degree and distribution of lesions in the two groups were similar (P> 0.05). The cardiac weight and left ventricular wall thickness in atrial fibrillation group and control group were 5 ± 81.9), (398.7 ± 82.2) g, P <0.01; (1.42 ± 0.34), (1.27 ± 0.32) cm, P <0.05 ]. There were no significant differences in the number of vessels in the paroxysmal atrial fibrillation group between the 17 cases of grade IV lesion and the 5 cases of the control group (P <0.05) P> 0.05). Conclusion The incidence of coronary heart disease in elderly patients is high, but there is no clear causal relationship with atrial fibrillation.