中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2010年
9期
670-674
,共5页
刘丁%杨媛华%张创业%王辰
劉丁%楊媛華%張創業%王辰
류정%양원화%장창업%왕신
肺栓塞%心电描记术
肺栓塞%心電描記術
폐전새%심전묘기술
Pulmonary thromboembolism%Electrocardiogam
目的 探讨急性肺血栓栓塞症(PTE)患者治疗前后心电图表现的动态变化.方法 将2002年6月至2005年12月全国多中心明确诊断的288例PTE患者分为大面积及次大面积组(A组)136例,非大面积组(B组)152例,其中男168例,女120例,年龄25～82岁,平均(55±14)岁.A组使用尿激酶或重组组织型纤溶酶原激活剂(rt-PA)进行溶栓治疗,B组使用普通肝素或低分子肝素抗凝治疗.在治疗前和治疗后14 d内观察患者心电图的表现,分析各段各种异常心电图的发生率,及A组和B组之间的差异.结果 SⅠ QⅢ TⅢ最高发生率为A组32.4%,B组21.7%,QⅢ波型:A组达69.1%,B组56.6%;TⅢ波型:A组63.2%,B组43.4%,SⅠ TⅢ波型:A组40.7%,B组25.7%,改变呈逐渐下降趋势且各时段间差异有统计学意义(P＜0.05);治疗前胸前导联Tv1倒置A组达77.8%,B组52.0%,Tv1-Tv5倒置依次变浅或消失,发生率呈下降趋势,各导联及各时段间差异有统计学意义;RaVR SV5振幅呈规律性递减趋势;电轴左偏A组最高发生率47.1%、B组30.3%,组间比较差异有统计学意义(P＜0.05).电轴右偏A组为16.2%,B组为15.1%,组间比较差异无统计学意义.结论 急性PTE患者心电图波型异常改变有较高发生率,对急性PTE患者的早期初步诊断有一定价值.
目的 探討急性肺血栓栓塞癥(PTE)患者治療前後心電圖錶現的動態變化.方法 將2002年6月至2005年12月全國多中心明確診斷的288例PTE患者分為大麵積及次大麵積組(A組)136例,非大麵積組(B組)152例,其中男168例,女120例,年齡25～82歲,平均(55±14)歲.A組使用尿激酶或重組組織型纖溶酶原激活劑(rt-PA)進行溶栓治療,B組使用普通肝素或低分子肝素抗凝治療.在治療前和治療後14 d內觀察患者心電圖的錶現,分析各段各種異常心電圖的髮生率,及A組和B組之間的差異.結果 SⅠ QⅢ TⅢ最高髮生率為A組32.4%,B組21.7%,QⅢ波型:A組達69.1%,B組56.6%;TⅢ波型:A組63.2%,B組43.4%,SⅠ TⅢ波型:A組40.7%,B組25.7%,改變呈逐漸下降趨勢且各時段間差異有統計學意義(P＜0.05);治療前胸前導聯Tv1倒置A組達77.8%,B組52.0%,Tv1-Tv5倒置依次變淺或消失,髮生率呈下降趨勢,各導聯及各時段間差異有統計學意義;RaVR SV5振幅呈規律性遞減趨勢;電軸左偏A組最高髮生率47.1%、B組30.3%,組間比較差異有統計學意義(P＜0.05).電軸右偏A組為16.2%,B組為15.1%,組間比較差異無統計學意義.結論 急性PTE患者心電圖波型異常改變有較高髮生率,對急性PTE患者的早期初步診斷有一定價值.
목적 탐토급성폐혈전전새증(PTE)환자치료전후심전도표현적동태변화.방법 장2002년6월지2005년12월전국다중심명학진단적288례PTE환자분위대면적급차대면적조(A조)136례,비대면적조(B조)152례,기중남168례,녀120례,년령25～82세,평균(55±14)세.A조사용뇨격매혹중조조직형섬용매원격활제(rt-PA)진행용전치료,B조사용보통간소혹저분자간소항응치료.재치료전화치료후14 d내관찰환자심전도적표현,분석각단각충이상심전도적발생솔,급A조화B조지간적차이.결과 SⅠ QⅢ TⅢ최고발생솔위A조32.4%,B조21.7%,QⅢ파형:A조체69.1%,B조56.6%;TⅢ파형:A조63.2%,B조43.4%,SⅠ TⅢ파형:A조40.7%,B조25.7%,개변정축점하강추세차각시단간차이유통계학의의(P＜0.05);치료전흉전도련Tv1도치A조체77.8%,B조52.0%,Tv1-Tv5도치의차변천혹소실,발생솔정하강추세,각도련급각시단간차이유통계학의의;RaVR SV5진폭정규률성체감추세;전축좌편A조최고발생솔47.1%、B조30.3%,조간비교차이유통계학의의(P＜0.05).전축우편A조위16.2%,B조위15.1%,조간비교차이무통계학의의.결론 급성PTE환자심전도파형이상개변유교고발생솔,대급성PTE환자적조기초보진단유일정개치.
Objective To research variety orderliness of electrocardiogram in patients with acute pulmonary thromboembolism(PET). Method 288 patients with first episode of acute PET were included in the study: There were 136 patients with massive and sub massive PTE (group A) and 152 with non-massivePET (group B). Thrombolytic agents were used for patients in group A and anticoagulant agents for those in group B. The electrocardiographic patterns of these patients were observed on 6 time points during the course. The rate of electrocardiographic abnormalities and differences between groups were analyzed. Result A high rate of S 1 Q Ⅲ T Ⅲ change was observed, 32. 4% (44/136 ) in group A and 21.7 % ( 33/152 ) in group B. QⅢ ,TⅢ ,and S Ⅰ TⅢ were also very common. Negative T-waves in precordial leads were present in 77. 8%(105/136) of patients in group A,and 52. 0% (79/152) in group B. The amplitude of RavR and Sv5 was decreased gradually and regularly after treatment. The highest rate of left axis deviation was 47.06% in group A and 30. 26% in group B, the difference being significant between the 2 groups. The occurrence of right axis deviation was lower, 16.2% (22/136)in group A and 15. 1% (23/152)in group B, with no significant difference. Conclusion The electrocardiographic findings were useful in the early diagnosis of PTE.
