中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2015年
3期
415-418
,共4页
孙中吉%吴素丽%王萌%仇海军
孫中吉%吳素麗%王萌%仇海軍
손중길%오소려%왕맹%구해군
冠心病%高血压,肺性%心功能不全%V1导联P波终末电势
冠心病%高血壓,肺性%心功能不全%V1導聯P波終末電勢
관심병%고혈압,폐성%심공능불전%V1도련P파종말전세
Coronary disease%Hypertension,pulmonary%Cardiac insufficiency%P-wave terminal force in lead V1
目的：探讨冠心病心功能不全伴肺动脉压力升高者心电图V1导联P波终末电势（PTFV1）改变的影响。方法选择2011年1月至2013年12月160例冠心病心功能不全的住院患者，依据多普勒超声测量的肺动脉压（PAP）升高和正常分为2组：肺动脉压升高，PAP≥40 mmHg的98例为试验组；肺动脉压正常，PAP＜40 mmHg的62例为对照组。计算两组患者超声测量的E峰/A峰比值（E/A）、左室射血分数（EF）、PAP和心电图PTFV1值，比较两组间总的差异性。与此同时，比较试验组中肺动脉压力轻度（PAP=40～50 mmHg）、中度（PAP=51～70 mmHg）和重度升高（PAP≥70 mmHg）对PTFV1值的影响。结果（1）试验组的E/A和EF值低于对照组[0.85±0.17、（41.4±10.26）%]vs.[1.03±0.22、（48.1±7.03）%]，P＜0.05]，而PTFV1绝对值却大于对照组[-（0.116±0.044）mm/s vs.-（0.085±0.029）mm/s，P＜0.01]，说明试验组心室舒张和收缩功能减退程度大于对照组， PTFV1绝对值的增大与心衰的严重程度相一致。（2）在PAP轻度、中度和重度升高的试验组患者中，PTFV1绝对值也依次增大，分别为-（0.089±0.027）mm/s、-（0.136±0.034） mm/s和-（0.202±0.031）mm/s，其差异均有显著性统计学意义（P＜0.01），表明PTFV1绝对值伴随PAP的升高而增大。结论 PTFV1绝对值的增大与冠心病心功能不全和PAP升高有明显的相关性，动态监测心电图PTFV1值的变化对于认识左心功能不全伴发的被动性肺动脉压的升高有重要的临床意义。
目的：探討冠心病心功能不全伴肺動脈壓力升高者心電圖V1導聯P波終末電勢（PTFV1）改變的影響。方法選擇2011年1月至2013年12月160例冠心病心功能不全的住院患者，依據多普勒超聲測量的肺動脈壓（PAP）升高和正常分為2組：肺動脈壓升高，PAP≥40 mmHg的98例為試驗組；肺動脈壓正常，PAP＜40 mmHg的62例為對照組。計算兩組患者超聲測量的E峰/A峰比值（E/A）、左室射血分數（EF）、PAP和心電圖PTFV1值，比較兩組間總的差異性。與此同時，比較試驗組中肺動脈壓力輕度（PAP=40～50 mmHg）、中度（PAP=51～70 mmHg）和重度升高（PAP≥70 mmHg）對PTFV1值的影響。結果（1）試驗組的E/A和EF值低于對照組[0.85±0.17、（41.4±10.26）%]vs.[1.03±0.22、（48.1±7.03）%]，P＜0.05]，而PTFV1絕對值卻大于對照組[-（0.116±0.044）mm/s vs.-（0.085±0.029）mm/s，P＜0.01]，說明試驗組心室舒張和收縮功能減退程度大于對照組， PTFV1絕對值的增大與心衰的嚴重程度相一緻。（2）在PAP輕度、中度和重度升高的試驗組患者中，PTFV1絕對值也依次增大，分彆為-（0.089±0.027）mm/s、-（0.136±0.034） mm/s和-（0.202±0.031）mm/s，其差異均有顯著性統計學意義（P＜0.01），錶明PTFV1絕對值伴隨PAP的升高而增大。結論 PTFV1絕對值的增大與冠心病心功能不全和PAP升高有明顯的相關性，動態鑑測心電圖PTFV1值的變化對于認識左心功能不全伴髮的被動性肺動脈壓的升高有重要的臨床意義。
목적：탐토관심병심공능불전반폐동맥압력승고자심전도V1도련P파종말전세（PTFV1）개변적영향。방법선택2011년1월지2013년12월160례관심병심공능불전적주원환자，의거다보륵초성측량적폐동맥압（PAP）승고화정상분위2조：폐동맥압승고，PAP≥40 mmHg적98례위시험조；폐동맥압정상，PAP＜40 mmHg적62례위대조조。계산량조환자초성측량적E봉/A봉비치（E/A）、좌실사혈분수（EF）、PAP화심전도PTFV1치，비교량조간총적차이성。여차동시，비교시험조중폐동맥압력경도（PAP=40～50 mmHg）、중도（PAP=51～70 mmHg）화중도승고（PAP≥70 mmHg）대PTFV1치적영향。결과（1）시험조적E/A화EF치저우대조조[0.85±0.17、（41.4±10.26）%]vs.[1.03±0.22、（48.1±7.03）%]，P＜0.05]，이PTFV1절대치각대우대조조[-（0.116±0.044）mm/s vs.-（0.085±0.029）mm/s，P＜0.01]，설명시험조심실서장화수축공능감퇴정도대우대조조， PTFV1절대치적증대여심쇠적엄중정도상일치。（2）재PAP경도、중도화중도승고적시험조환자중，PTFV1절대치야의차증대，분별위-（0.089±0.027）mm/s、-（0.136±0.034） mm/s화-（0.202±0.031）mm/s，기차이균유현저성통계학의의（P＜0.01），표명PTFV1절대치반수PAP적승고이증대。결론 PTFV1절대치적증대여관심병심공능불전화PAP승고유명현적상관성，동태감측심전도PTFV1치적변화대우인식좌심공능불전반발적피동성폐동맥압적승고유중요적림상의의。
Objective To investigate the effect of pulmonary artery pressure (PAP) on P-wave terminal force in lead V1 (PTFV1), that associated with cardiac insufficiency in patients of coronary heart disease.Methodsfrom January, 2011 to December, 2013, based on Doppler ultrasound measurement of pulmonary artery pressure (PAP), 160 cases of coronary heart disease with cardiac insufficiency were divided into 2 groups: 98 cases were greater than 40 mmHg in trial group; 62 cases were less than 40 mmHg as control group. The E peak/A peak ratio (E/A), left ventricular ejection fraction (EF) and PAP of two groups were calculated by ultrasound, at the same time, the PTFV1 of ECG were measured. Then, those data were compared between the two groups. Meanwhile, comparing the effect of PAP on PTFV1, PAP of 40-50 mmHg, 51-70 mmHg and more than 70 mmHg which in the trial group.Results (1)The E/A and EF value in trial group were lower than that in normal group, the result was 0.85±0.17, (41.4±10.26)%vs. 1.03±0.22, (48.1±7.03)%,P<0.05 andP<0.01, but the PTFV1 absolute value in trial group were higher than that in normal group, the result was-(0.116±0.044)mm/svs.-(0.085±0.029)mm/s, P<0.01, which showed that increased PTFV1 was companied by decreased E/A and EF. There was no doubt to ventricular diastolic and systolic dysfunction in trial group was greater than in normal group. (2) The values of PTFV1 of patience with mild, moderate and severe increase of PAP were-(0.089±0.027)mm/s,-(0.136±0.034)mm/s and-(0.202±0.031)mm/s, respectively. There is difference among them, andP<0.01. Obviously, there was a correlation between PTFV1 had something to do with and PAP.Conclusion There is a correlation between the increased PTFV1 and increased PAP which happens in coronary heart disease patients who have heart dysfunction. It is of important significance for guiding the clinicians towards the better understanding of increased PAP in coronary heart disease with heart dysfunction.
