急慢性肺栓塞心电图及超声心动图的对比.doc

急慢性肺栓塞心电图及超声心动图的对比
【摘要】目的：了解在急慢性肺栓塞中常规十二导联心电图及超声心动图的表现及其不同之处。方法：回顾性研究从2001年1月到2007年3月53例住院肺栓塞患者的资料，对象被分为急性肺栓塞组（24例）及慢性肺栓塞组（29例）；分析急、慢性肺栓塞的心电图及超声心动图（包括右房右室大小，肺动脉压力，左房左室大小等）表现。结果：两组病人中绝大多数病人均有心电图的异常，急性组病人更多见SⅠ、QⅢ（P均<0.05）。而慢性组心房颤动发生率明显高于急性组（P＜0.01），且RⅥ增高，RⅥ＞1.0mV例数增多（P均＜0.05）；两组病人超声心动图表现不同程度的肺动脉压力升高，慢性组右房、室扩大更为明显（P<0.01，<0.05）。结论：常规心电图，超声心动图在急慢性肺栓塞中表现不同，具有诊断价值。
【关键词】肺栓塞超声心动描记术心电描记术
Comparisonofelectrocardiogramandechocardiographyinpatientswithacuteandchronicpulmonaryembolism/
WULian|pin,GUANXue|qiang,ZHANGSu|qin,TANGJi|fei,YANGPeng|lin,YINGBin|yu,WANGPing|xiao,QIAOJian|hong,SONGXi|fa//
Abstract：Objective:Toknowthedifferenceofelectrocardiogramandechocardiographyinpatientswithacutepulmonaryembolism(APE)andchronicpulmonaryembolism(CPE).Methods:Allofthe53in|hospitalpatientswithpulmonaryembolismfrom2001.01to2007.03weredividedintotwogroups:Acutepulmonaryembolismgroup(24cases)andchronicpulmonaryembolism(29cases).Thechangeofelectrocardiogramandechocardiography(include:thesizeoffourchambers,thepressureofthepulmonaryarteryetc.)wereretrospectivelyanalyzedandcomparedbetweentwogroups.Results:Therewereabnormalchangesofelectrocardiograminabsolutemajorityofpatients.InAPEgroup,morepatientshadSⅠ、QⅢmanifestation(P<0.05all);however,morepatientshadthemanifestationofatrialfibrillation(P＜0.01),RⅥmVincreased(P＜0.05),thepatientnumberofRⅥ>1.0mVincreased(P<0.05)inCPEgroup.Echocardiogramappearance:①Elevationofthepressureofthepulmonaryarterybydifferentdegree;②Dilationoftherightatriumandventriclebydifferentdegree;DilationoftherightatriumandventricleworseninCPEgroup(P<0.01,<0.05).Conclusion:Themanifestationofelectrocardiogramandechocardiography,whichplaceadiagnosticrole,isdifferentinacuteandchronicpulmonaryembolism.
Author′saddress：DepartmentofCardiology，SecondAffiliatedHospitalofWenzhouMedicalCollege,Wenzhou,Zhejiang,325000,China
Keywords：Pulmonaryembolism;Echocardiography;Electrocardiography肺动脉栓塞（Plumonnyembolism）是指各种栓子堵塞肺动脉或其分支引起肺循环障碍的一种临床综合征。急性肺栓塞发病急，临床表现多种多样且无特异症状，误诊率及病死率均较高。目前临床上对此疾病认识尚不足，误诊率