额面P波电轴与慢性阻塞性肺疾病相关性研究

发布时间：2019-02-13 03:46

【摘要】：目的:通过观察慢性阻塞性肺疾病患者心电图额面P波电轴(?P)水平,以及分析其分别与体重指数(BMI)、残总比(RV/TLC)、吸气分数(IC/TLC)、第一秒用力呼气容积占预计值百分比(FEVI%pred)、MMRC评分指数、CAT评分相关性、COPD综合评估的关系,探讨?P在COPD患者诊断筛查、病情严重程度和预后评估中临床应用价值。方法:选择2016年07月至2017年01月在昌吉州人民医院内科门诊就诊或住院的慢性阻塞性肺疾病患者107名(男85例,女22例,年龄为63.70±9.26)为试验组,同期在门诊体检并与入选研究组性别、年龄相匹配健康人107名(男性85名,女性22名,平均年龄为62.27±8.75岁)为对照组。对试验组和对照组受试者测得身高、体重,行心电图及肺功能检查,对107例COPD受试者行改良的英国医学会研究委员会呼吸困难量表(MMRC)评分、慢性阻塞肺疾病评估测试(CAT)评分,依据COPD综合评估把试验组107名COPD患者分为4级:A级、B级、C级、D级;各组数据用SPSSl7.0软件进行统计学分析,比较额面P电轴在慢性阻塞肺疾病试验组与正常对照组间,A、B、C、D4级间差别,并分析额面P波电轴分别与体重指数(BMI)、吸气分数(IC/TLC)、残总比(RV/TLC)、第一秒用力呼气容积占预计值百分比(FEVI%pred)、MMRC评分指数、CAT生活质量评分相关性。结果:1.慢性阻塞性肺疾病患者额面P波电轴显著大于正常对照组(P0.05);2.额面P电轴与BMI呈负相关(r=-0.203,P0.05)、与RV/TLC呈正相关(r=0.451,P0.01)、与IC/TLC呈负相关(r=-0.503,P0.01)、与FEVl%pmd呈负相关(r=-0.352,P0.01)、与mMRC评分呈正相关(r=0.432,P0.01)、与CAT评分呈正相关(r=0.405,P0.01)。3.COPD患者综合评估分级各级?P的比较:D级额面P电轴明显高于A级(P0.01)、B和C级(P0.05),A级额面P电轴低于B、C两级(P0.05),余不同级别间无统计学差异。结论:1.额面P波电轴垂直化在慢性阻塞性肺疾病诊断方面的敏感性、特异性均较高,有一定临床应用价值,并可用于评估其严重程度。
[Abstract]:Objective: to observe the level of P wave axis (? P) in frontal surface of patients with chronic obstructive pulmonary disease (COPD), and to analyze its correlation with body mass index (BMI),) residual total ratio (RV/TLC), inspiratory fraction (IC/TLC), body mass index (BMI), total residual ratio (RV/TLC) and inspiratory fraction (IC/TLC). The percentage of forced expiratory volume in the first second (FEVI%pred), MMRC score, CAT score correlation, COPD comprehensive evaluation), to explore the clinical value of P in the diagnosis and screening, severity and prognosis evaluation of COPD patients. Methods: 107 patients with chronic obstructive pulmonary disease (85 males, 22 females, age 63.70 卤9.26) were selected as experimental group. 107 healthy subjects (85 males and 22 females, with an average age of 62.27 卤8.75 years) were matched with the sex and age of the study group at the same time. Height, weight, electrocardiogram and pulmonary function were measured in the test group and the control group, and (MMRC) scores of the modified BMA Respiratory dyspnea scale were performed on 107 subjects with COPD. According to the (CAT) score of chronic obstructive pulmonary disease evaluation test, 107 COPD patients in the trial group were divided into four grades: grade A, grade B, grade C and grade D according to the comprehensive evaluation of COPD. The data of each group were statistically analyzed by SPSSl7.0 software. The differences of frontal P axis and body mass index (BMI),) were compared between the chronic obstructive pulmonary disease test group and the normal control group, and the frontal P wave axis was compared with the body mass index (BMI),). Inspiratory fraction (IC/TLC), total residual ratio (RV/TLC), forced expiratory volume in the first second as a percentage of predicted value (FEVI%pred), MMRC score, CAT quality of life score) were correlated. Results: 1. P wave axis of frontal surface in patients with chronic obstructive pulmonary disease was significantly higher than that in normal control group (P0.05). There was a negative correlation between frontal P axis and BMI (P 0.05), positive correlation with RV/TLC (r P 0.01), negative correlation between P axis and IC/TLC (r P 0.01), and negative correlation between P axis and FEVl%pmd. There was a positive correlation with the mMRC score (r = 0.432P 0.01) and a positive correlation with the CAT score (r = 0.405, P < 0.05). Comparison of 3.COPD patients' comprehensive evaluation grade? P: grade D frontal P axis was significantly higher than A grade (P0.01), B and C grade (P0.05), A frontal P axis was lower than), A C grade (P0.05). There was no statistical difference between different grades. Conclusion: 1. The sensitivity and specificity of frontal P wave axis perpendicularity in the diagnosis of chronic obstructive pulmonary disease (COPD) is high. It has certain clinical application value and can be used to evaluate its severity.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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