老年COPD呼吸衰竭患者的心律失常

CARDIAC ARRHYTHMIA IN ELDERLY COPD PATIENTS WITH RESPIRATORY FAILURE

目的 提高对老年 COPD呼吸衰竭的心律失常的认识。 方法 回顾性分析 107例老年 COPD呼吸衰竭因下呼吸道感染而急性加剧的住院患者发生心律失常的情况。全部病例均于入院时及治疗后行常规 12导联心电图检查， 78例行 24h动态心电图检查及 46例行连续动态心电监护。 结果 本组入院时急性期心律失常发生率 54.2％ (58/107)，治疗后缓解期为 17.39％。室上性，室性激动异常及束支传导阻滞均可见，室性早搏在年龄大于 70岁中更多见 (32.89％ )，缺 O2和 CO2储留及 FEV1％均与心律失常明显相关。 结论 积极纠正缺 O2和 CO2储留，防治感染，改善 FEV1％为减少呼衰并心律失常的关键之一。

Objective To increase the awareness of cardiac arrhythmia in elderly COPD patients with respiratory failure. Methods Cardiac arrhythmia in 107 hospitalized elderly COPD patients with respiratory failure aggravated by lower respiratory tract infection were analyzed retrospectively. Routins 12－ lead electrocardiogram for all cases, 24h, Holter recording for 78 of them and continuous ECG monitoring for 46 patients were performed. Results Among 107 patients, cardiac arrhythmia was detected in 58 of them(54.2％ ) on admission. The percentage reduced to 17.9％ after appropriate treatment. The superventricular and ventricular dysrhythmias, and the conduction disturbance could be observed frequently in present series. Cardiac arrhythmia was apparently correlated to PO2, PCO2 and FEV1％ . Conclusions Effective control of lower respiratory tract infection and correction of PO2 and PCO2 were critically important in the treatment of cardiac arrhythmia in elderly COPD patients with respiratory failure.