浅析慢性阻塞性肺疾病患者心电图差异

Analysis of Electrocardiographic Abnormalities in Patients with Chronic Obstructive Pulmonary Disease

目的探索重度与轻中度慢性阻塞性肺疾病患者心电图差异。方法采用盲法分析70位重度慢性阻塞性肺疾病患者(A组)和90位轻中度慢性阻塞性肺疾病患者(B组)的心电图。结果右心房扩大发生率A组44%,B组15%(P<0.001)。右心室肥大发生率A组29%,B组4%(P<0.001)。右束支传导阻滞发生率A组29%,B组11%(P<0.01)。心电轴顺时针旋转发生率A组40%,B组18%(P<0.005)。Ⅲ和aVF出现QS的发生率A组16%,B组4%(P<0.01)。心电轴左偏发生率A组16%,B组4%(P<0.05)。房性早搏发生率A组19%,B组7%(P<0.05)。室上性快速性心律失常发生率A组16%,B组5%(P<0.025)。结论重度慢性阻塞性肺疾病患者心电图中右心房扩大、右心室肥大、右束支传导阻滞、心电轴顺时针旋转、Ⅲ和aVF出现QS、心电轴左偏和室上性快速性心律失常的发生率均高于轻中度慢性阻塞性肺疾病患者。

Objective To observe the prevalence of some electrocardiographic （ECG） abnormalities in severe and mild or moderate chronic obstructive pulmonary disease （COPD）. Methods ECGs were interpreted by blind - analysis in 70 patients with severe COPD （ group A） versus 90 patients with mild or moderate COPD （group B）. Results Right atrial enlargement （RAE） occurred in 44% patients of group A and 15% of group B （P 〈0. 001 ）. Right ventricular hypertrophy （RVH） occurred in 29%o patients of group A and 4% of group B （P 〈 0. 001）. Right bundle branch block （RBBB） occurred in 29%o patients of group A and 11% of group B （P 〈 0.01 ）. Marked clockwise rotation of heart occurred in 40% patients of group A and 18%o of group B （P 〈 0. 005）. QS pattern in leads Ⅲ and aVF occurred in 16% patients of group A and 4% of group B （P 〈 0.01）. Left axis deviation （LAD） occurred in 16% patients of group A and 4% of group B （P 〈 0.05）. Premature atrial complexes （PACs） occurred in 19% patients of group A and 7% of group B patients （P 〈 0.05）. Supraventricular tachyarrhythmias （SVTs） occurred in 16% patients of group A and 5% of group B （P 〈 0. 025）. Conclusion RAS, RVH, RBBB, marked clockwise rotation of heart, a QS pattern in leads Ⅲ and aVF, LAD, PACs, and SVTs were significantly more prevalent in patients with severe COPD than in patients with mild or moderate.