急性肺栓塞不同危险分层与心电变化的关系

The relation between risk stratification of acute pulmonary embolism and electrocardiographic changes

目的探究急性肺栓塞不同危险分层与心电变化的关系。方法选取2016年1月至2019年1月急性肺栓塞患者90例,根据危险分层进行分组。其中,低危组35例,中危组30例,高危组25例。均行心电图及动态心电图检查,心电图观察指标为心率、P波、QRS波群、T波、ST段变化,动态心电图观察指标心率变异性及心律失常。结果高危组窦性心动过速、肺型P波、SⅠQⅢTⅢ、ⅢST段抬高、V1ST段抬高、V1~V4T波倒置发生率均高于低危组,高危组ⅢST段抬高、V1ST段抬高、V1~V4T波倒置发生率高于中危组,差异均有统计学意义(均P<0.05)。高危组心率变异性指标正常RR间期标准差(SDNN)、每5min正常RR间期平均值的标准差SDANN均低于中、低危组,差异有统计学意义(均P<0.05)。高危组患者室性心律失常、室上性心律失常、房室传导阻滞及束支传导阻滞阳性率均高于中危组和低危组,差异均有统计学意义(均P<0.05)。结论急性肺栓塞时心电图改变与危险分层相关。

Objective To explore the relation between risk stratification of acute pulmonary embolism(APE)and electrocardiographic(ECG)changes.Methods 90 patients with APE were enrolled from January 2016 to January 2019 and divided into low risk(n=35),middle risk(n=30)and high risk(n=25)groups according to risk stratification of APE.Surface ECG and dynamic ECG were performed in all cases.Heart rate,P wave,QRS wave,T wave and ST segment on surface ECG,heart rate variability and arrhythmias on dynamic ECG were analyzed.Results The incidences of sinus tachycardia,pulmonary P wave,SⅠQⅢTⅢ、STⅢelevation,STV1 elevation and V1~V4 T wave inversion were significantly higher in high risk group than in low risk groups(all P<0.05).The incidences of STⅢelevation,STV1 elevation and V1~V4 T wave inversion were significantly higher in high risk group than middle risk group(all P<0.05).The standard deviation of normal RR interval and standard deviation of sequential five-minute R-R interval means were significantly lower in high risk group than in middle and low risk groups(all P<0.05).The incidences of ventricular arrhythmias,supraventricular arrhythmias,atrioventricular and bundle branch block were significantly higher in high risk group than in middle and low risk groups(all P<0.05).Conclusion The electrocardiographic changes are related to risk stratification of APE.