老年慢性肺原性心脏病合并冠心病临床分析

Clinical features of aged patients with chronic pulmonary heart disease and coronary heart disease

目的：探讨老年慢性肺心病合并冠心病的的临床特点。方法：回顾分析福建省老年医院2002年1月至2006年12月期间82例老年慢性肺心病合并冠心病患者（A组）和195例老年单纯慢性肺心病患者（B组）的临床资料，比较分析两组患者的临床特点。结果：两组比较是易患因素高血压、糖尿病和肥胖比例有显著差别（P〈0．05），临床表现陈旧性心肌梗塞史、完全性左束枝传导阻滞（LBBB）、心界向左或向左下扩大、持续缺血的ST—T改变、Ⅱ～Ⅲ度房室传导阻滞、电轴右偏和重度右心衰竭有显著差别（P〈0．05）。结论：慢性肺心病患者若有陈旧性心肌梗塞史、高血压、糖尿病、肥胖或LBBB、心界向左或左下扩大应考虑合并冠心病。

Objective： To analyze the clinic features of aged patients with chronic Pulmonary heart disease （PHD） and coronary heart disease （CHD）. Methods： Clinical data of 82 patients with PHD and CHD （group A） and 195 patients of chronic pulmonary heart disease （group B）from 2002 to 2006 in our hospital were analyzed comparatively. Results： Between two group, the significant differential risk factors （P〈0. 01 all） were hypertension, diabetes and adiposity, the significant differential clinical manifestation were old myocardial infarction, complete left bundle branch block （LBBB）, heart border expand to left. Ⅱ～Ⅲ° A-V block. ECG right-axis deviation and severe right heart failure. Conclusion.. The patients with chronic PHD must be consider complicated with coronary heart disease when have hypertension, diabetes, adiposity, old myocardial infarction, complete LBBB, heart border expand to left, sustained-ischemia S-T change and Ⅱ～Ⅲ° A-V block.