慢性阻塞性肺疾病93例立体心电向量图分析

发布时间：2018-06-27 15:51

本文选题：肺疾病 + 慢性阻塞性　；参考：《辽宁医学院》2012年硕士论文

【摘要】：目的探讨立体心电向量图对慢性阻塞性肺疾病（COPD）肺动脉高压引起的心脏结构和血流动力学变化的诊断意义。方法 93例COPD患者依心脏彩超分为三组：A组为无肺动脉高压组34例（男15例，女19例），B组为肺动脉高压组33例（男13例，女20例），C组为肺动脉高压并右心室肥大组（男10例，女16例）26例。记录立体心电向量图，分析肺动脉压升高和右心室肥大对QRS最大向量及心室复极梯度振幅、方位（仰角、方位角），空间QRS-T夹角、比值的影响；对B组进一步分析肺动脉压升高与上述指标的关系。结果（1）QRS最大向量方位角、心室复极梯度方位角：B组（-62.20±57.01、-56.72±28.18）较A组（-23.54±32.97、-9.22±27.92）、C组（-135.74±26.03、-139.36±40.70）较B组（-62.20±57.01、-56.72±28.18）负值均增大，差异有显著统计学意义（P＜0.01），QRS-T夹角B组较A组增大，差异有显著统计学意义（P＜0.01）；（2）B组QRS-T夹角、心室复极梯度方位角均与肺动脉压升高程度直线相关（r1=0.89，P1＜0.05；r2=-0.86，P2＜0.05）。结论（1）QRS最大向量、心室复极梯度方位角负值增大均有助COPD患者肺动脉高压及肺动脉高压并右心室肥大的识别；（2）在无右心室肥大时，，QRS-T夹角、心室复极梯度方位角的增加可反映肺动脉高压的程度，随着QRS-T夹角的增大、心室复极梯度方位角的减小，肺动脉高压越明显。
[Abstract]:Objective to investigate the diagnostic significance of stereoscopic electrocardiogram (STVG) in the changes of cardiac structure and hemodynamics in patients with pulmonary hypertension caused by chronic obstructive pulmonary disease (COPD). Methods 93 patients with COPD were divided into three groups according to color Doppler echocardiography: 34 cases (15 males, 19 females) without pulmonary hypertension in group A, 33 cases (13 males) in group B with pulmonary hypertension. Group C consisted of 26 patients with pulmonary hypertension and right ventricular hypertrophy (male 10, female 16). The effects of elevated pulmonary artery pressure and right ventricular hypertrophy on QRS maximum vector amplitude, azimuth (elevation, azimuth), spatial QRS-T angle and ratio were recorded. In group B, the relationship between pulmonary hypertension and the above indexes was further analyzed. Results (1) the maximum vector azimuth angle of QRS and the negative value of ventricular repolarization gradient azimuth angle in group B (-62.20 卤57.01U -56.72 卤28.18) were significantly higher than those in group C (-135.74 卤26.03-139.36 卤40.70) and group B (-62.20 卤57.01) -56.72 卤28.18 (P < 0.01). The difference was statistically significant (P < 0. 01); (2). The angle of QRS-T and the azimuth of ventricular repolarization gradient in group B were all correlated with the degree of pulmonary artery pressure elevation (R1: 0. 89, P1 < 0. 05, r2- 0. 86, P 2 < 0. 05). Conclusion (1) the maximum QRS vector and the negative azimuth of the ventricular repolarization gradient are helpful for the recognition of pulmonary hypertension and pulmonary hypertension associated with right ventricular hypertrophy in COPD patients, and (2) the QRS-T angle is found in the absence of right ventricular hypertrophy. The increase of ventricular repolarization gradient azimuth angle can reflect the degree of pulmonary hypertension. With the increase of QRS-T angle and the decrease of ventricular repolarization gradient azimuth angle, pulmonary hypertension becomes more obvious.
【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9

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