CAJ | 학술논문

目的：探讨心电图评分对急性肺栓塞（acute pulmonary embolism，APE）危险程度的预测价值。方法回顾性分析2012年1月~2014年1月期间我院接受治疗的108例急性肺栓塞患者的临床资料，根据患者病情将患者分为低危组41例，中危组61例，高危组6例。患者入院24 h内采集其心电图，研究心电图波形与危险分层的关系，分析心电图T波导致导联数与右室前后径、肺动脉收缩压（SPAP）、动脉血二氧化碳分压（PaCO2）、血液酸碱度（pH值）、动脉血氧分压（PaCO2）的关系。结果急性肺栓塞患者常见的心电图改变：胸前导联出现193例T波倒置，其中以86例V1患者、58例V2患者为主，其次还有49例V3患者。心电图T波倒置导联数与动脉血pH值、右心室前后径、PaCO2没有相关性。心电图T波倒置导联数与SPAP呈正相关，与动脉血气分析中PaO2呈负相关。结论心电图与急性肺栓塞患者的严重程度有良好的相关性，使用心电图检测对急性肺栓塞患者有良好的预测价值。
목적：탐토심전도평분대급성폐전새（acute pulmonary embolism，APE）위험정도적예측개치。방법회고성분석2012년1월~2014년1월기간아원접수치료적108례급성폐전새환자적림상자료，근거환자병정장환자분위저위조41례，중위조61례，고위조6례。환자입원24 h내채집기심전도，연구심전도파형여위험분층적관계，분석심전도T파도치도련수여우실전후경、폐동맥수축압（SPAP）、동맥혈이양화탄분압（PaCO2）、혈액산감도（pH치）、동맥혈양분압（PaCO2）적관계。결과급성폐전새환자상견적심전도개변：흉전도련출현193례T파도치，기중이86례V1환자、58례V2환자위주，기차환유49례V3환자。심전도T파도치도련수여동맥혈pH치、우심실전후경、PaCO2몰유상관성。심전도T파도치도련수여SPAP정정상관，여동맥혈기분석중PaO2정부상관。결론심전도여급성폐전새환자적엄중정도유량호적상관성，사용심전도검측대급성폐전새환자유량호적예측개치。
Objective To explore the value of ECG score in predicting the danger level of acute pulmonary embolism (APE). Methods Clinical data of 108 patients with APE who were admitted to and treated in our hospital from January 2012 to January 2014 were retrospectively analyzed. According to patients' disease conditions, 41 patients were as-signed to low-risk group, 61 patients in medium-risk group, and 6 patients in high risk group. ECG was carried out for patients 24 hours after the admission. Relations between waves of ECG and risk stratification were studied. Relations of number of leads by ECG T wave with anteroposterior diameter of right ventricle, SPAP, PaCO2, pH value and PaO2 were analyzed. Results Commonly seen changes of ECG for patients with APE were as follows: Precordial T wave inversion was seen in 193 patients, among whom patients were V1, and 58 patients were V2, followed by 49 cases of V3 patients. Number of leads by T wave inversion was not correlated with arterial blood pH value, anteroposterior diameter of right ventricle, and PaCO2. Number of leads by T wave inversion was positively correlated with SPAP, and was negatively correlated with PaO2 in arterial blood gas analysis. Conclusion ECG and the danger level of patients with APE have good correlations, and ECG has favorable predicting values for patients with APE.