84例老年及老年前期慢性阻塞性肺疾病病人信号平均心电图分析

Analysis of Signal-Averaged Electrocardiogram of 84 Elder Patients with COPD

目的：通过非侵入性方法早期发现ＣＯＰＤ病人的心脏损害。方法：８４例老年及老年前期ＣＯＰＤ病人（ＣＯＰＤ组）与相同年龄健康人（对照组）的信号平均心电图进行比较分析。结果：老年ＣＯＰＤ病人滤波后总ＱＲＳ时限较健康老人延长，ＱＲＳ终末部分电压小于４０μＶ的持续时间及ＱＲＳ最后４０ｍｓ均方根电压与对照组比较均有显著差异（分别为Ｐ＜０．０１及Ｐ＜０．００１）。ＣＯＰＤ组与对照组心室晚电位（ＶＬＰ）阳性率比较有显著性差异（Ｐ＜０．０１）。ＣＯＰＤ病人中，肺心病组与非肺心病组ＶＬＰ阳性率比较有显著性差异（Ｐ＜０．０１）。结论：老年ＣＯＰＤ病人尤其是肺心病病人心室晚电位阳性率增高，可能与ＣＯＰＤ病人“慢支”

bjective :To find out earlier the heart lesion in patients with chronic obstructive pulmonary disease(COPD) using uninvasive method.Method :The changes in signal-averaged electrocardiogram(SAECG)of COPD group and control group were analyzed.Results :The duration of total QRS(TQRS) in SAECG was longer in patients with COPD than in the normal subjects.There was a significant difference between the duration of the terminal part of the filtered QRS complex below 40μV,the mean root square of the voltage at the last 40ms in the COPD group and those in the control group( P <0.01, P <0.001,respectively).There was a marked difference between the positive rate of the ventricular late potentials(VLP) in COPD group and control group( P <0.01).A significant difference was found,too,between the VLP positive rate of the patients with and without chronic pulmonary heart disease.Conclusion :A increased VLP positive rate may be related to a intraventricular conduction disturbance due to a frequent relapse of`chronic brochitis'resulting cardiomyopathy.