急慢性肺栓塞心电图和超声心动图的对比.docVIP

【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＞1.0 mV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（P0.01，0.05）。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 　　 Comparison of electrocardiogram and echocardiography in patients with acute and chronic pulmonary embolism/ 　　WU Lian|pin,GUAN Xue|qiang,ZHANG Su|qin,TANG Ji|fei,YANG Peng|lin,YING Bin|yu,WANG Ping|xiao,QIAO Jian|hong,SONG Xi|fa// 　　Abstract：Objective:To know the difference of electrocardiogram and echocardiography in patients with acute pulmonary embolism(APE) and chronic pulmonary embolism(CPE).Methods:All of the 53 in|hospital patients with pulmonary embolism from 2001.01 to 2007.03 were divided into two groups:Acute pulmonary embolism group(24 cases) and chronic pulmonary embolism(29 cases).The change of electrocardiogram and echocardiography (include: the size of four chambers,the pressure of the pulmonary artery etc.) were retrospectively analyzed and compared between two groups.Results:There were abnormal changes of electrocardiogram in absolute majority of patients.In APE group,more patients had SⅠ、QⅢ manifestation(P0.05 all);however,more patients had the manifestation of atrial fibrillation (P＜0.01),RⅥ mV increased (P＜0.05),the patient number of RⅥ1.0 mV increased(P0.05) in CPE group.Echocardiogram appearance: ①Elevation of the pressure of the pulmonary artery by different degree;②Dilation of the right atrium and ventricle by different degree;Dilation of the right atrium and ventricle worsen in CPE group(P0.01,0.05).Conclusion:The manifestation of electrocardiogram and echocardiography,which place a diagnostic role,is different in acute and chronic pulmonary embolism. 　　Author′s　address：Department of Cardiology，Second Affiliated Hospital of Wenzhou Medical College,Wenzhou,Zhejian