慢性肺源性心脏病并发心律失常389例临床分析

A Clinical Study of Arrhythmias in Patients with Cor Pulmonale

目的探讨慢性肺源性心脏病(以下简称肺心病)心律失常的临床特征及治疗原则。方法本组患者共389例,全部于入院后48 h内通过24 h心电监护或多次常规12导联心电图检查,及时发现心律失常类型并加以分析。结果本组肺心病患者合并心律失常率达68.89%(268例),其心律失常类型以窦性心动过速、窦性心律不齐及房性期前收缩为主,严重心律失常如室上性心动过速、室性期前收缩、房室传导阻滞、心房颤动、左右束支传导阻滞等也常出现。心律失常的出现及严重程度与心力衰竭程度、肺部感染、低氧血症、水电解质紊乱等密切相关。结论肺心病心律失常发生率较高,且与肺心病患者病情严重程度密切相关,而心律失常治疗应通过积极的病因及并发症治疗,使用抗心律失常药物不是最佳办法。

Objective To study the clinical characteristics and therapeutic principles of arrhythmias complicated with cor pulmonale.MethodsPatients with cor pulmonale（n=389） were enrolled.The patients received 24-hour ambulatory or 12-lead electrocardiography（ECG） monitoring within 48 hours of enrollment.Arrhythmias were identified and analyzed.ResultsCor pulmonale patients were complicated with arrhythmias at a rate of 68.89%（n=268）.The arrhythmias consisted mainly of sinal tachycardia,sinal arrhythmia,and atrial premature contraction.Severe arrhythmias were also identified,such as supraventricular tachycardia,ventricular premature contraction,atrioventricular blockade,atrial fibrillation,and bundle transduction blockade.The occurrence and severity of arrhythmias were closely associated with cardiac failure,pulmonary infection,hypoxia,and water/electrolyte disturbance.ConclusionCore pulmonale is frequently complicated with arrhythmias whilst the severity of arrhythmias is closely associated with the underlying disease.The treatment of arrhythmias focuses on the management of cause and complications.The use of antiarrhythmics is not preferred for the treatment.