老年肺心病患者心电图V_1导联P波终末电势改变的临床意义

Clinical significance of the change of terminal force of P wave in lead V1 of electrocardiogram in elderly with cor pulmonale patients

目的探讨老年肺心病患者心电图Ｖ１导联Ｐ波终末电势（ＰｔｆＶ１）改变的临床意义。方法１８３例老年肺心病患者治疗前和治疗７～１０天后各查１次心电图１２个常规导联，测定其ＰｔｆＶ１值。结果治疗前ＰｔｆＶ１阳性者为１０１例（５５．２％），治疗后为５８例（３１．７％）（Ｐ＜０．０５）。治疗前ＰａＯ２降低时，ＰｔｆＶ１阳性率增高；左房扩大和（或）左室扩大者ＰｔｆＶ１阳性率较高。结论肺心病患者ＰｔｆＶ１阳性并不少见，且影响因素较多，不宜作为肺心病并存冠心病的诊断依据；但与肺心病的严重程度有关，值得重视。

Objective To evaluate the clinical significance of the change of terminal force of P wave in V1 (PtfV1). Methods One hundred and eighty three elderly patients with cor pulmonale were examined by ECG with 12 standard leads before and after a period of 7 to 10 days treatment to detect the values of the PtfV1. Results The positive rates of PtfV1 before and after treatment were 101(552%) cases and 58(317%) cases respectively. The lower value of PaO2 before treament results in higher positive rate of PtfV1. Positive rate of PtfV1 was higher in the patients with left atrium or(and) left ventricle enlargement. Conclusions The positive PtfV1 in cor pulmonale patients are common and there are many affecting factors. Although the result of positive PtfV1 should not be used as a diagnostic basis for the coexistence of cor pulmonale and coronary heart disease, it should be noted as related to the serious degree of the cor pulmonale.