慢性肺源性心脏病合并冠心病临床研究

Clinical Study of Chronic Pulmonary Heart Disease Complicated With Coronary Heart Disease

目的：探讨慢性肺源性心脏病（简称肺心病）合并冠心病的临床特点。方法选取2013年1～2014年12月于我院就诊的肺心病患者共134例作为研究对象，根据是否合并冠心病分为伴发组（n=64）和非伴发组（n=70）。比较两组患者易患因素、X线检查、治疗转归等临床特点。结果与非伴发组相比，伴发组高脂血症、高血压、糖尿病、肥胖发生率显著升高，比较有统计学差异（P均＜0.05），而吸烟发生比例组间比较无统计学差异（P＞0.05）。X线检查显示，伴发组左心室肥大和左右心室肥大的发生率分别为23.4%和14.06%，高于非伴发组10.0%和4.28%的发生率（P均＜0.05）。治疗后，与非伴发组相比，伴发组好转比例降低，比较有统计学意义（P＜0.05），治疗无效及死亡人数增加，但组间比较无统计学差异（P均＞0.05）。结论肺心病合并冠心病患者病情复杂，高脂血症、高血压、糖尿病、肥胖等易患因素、左心室肥大及左右心室肥大发生率明显升高，且治疗转归效果还有待进一步改善，应综合考虑进行相关诊断及治疗。

Objective To investigate the clinical characteristic of chronic pulmonary heart disease complicated with coronary heart disease.Methods From January, 2014 to December, 2014, 134 cases were selected as research subjects to retrospectively analyze their clinical characteristics. Those cases were divided into the none concomitant coronary heart disease group （NCCHD, n=84） and the concomitant coronary heart disease group （CCHD, n=92） according to if they were complicated with coronary heart disease. Then, the susceptible factors, x-ray examination, and outcomes were compared between the two groups.ResultsCompared to NCCHD group, CCHD group has higher rates of hypertension, hyperlipemia, obesity, and diabetes and same rates of smoke. The x-ray examination indicates CCHD group has higher rates of left ventricular hypertrophy （23.4%） and right ventricular hypertrophy （14.06%）, which are both higher than those of NCCHD group （10.0% and 4.28%）. After treatments, CCHD group has higher rates of mortality and invalid treatments （P〉0.05）, and lower rate of disease improvement （P〈0.05） than those of the NCCHD group.ConclusionHypertension, hyperlipemia, obesity, and diabetes are susceptible factors of CCHD. CCHD patients have higher incidence of left and ventricular hypertrophy, and poor prognosis and need more comprehensive treatments in the clinic.