心电图及X线胸片与CT综合诊断肺源性心脏病的临床价值  

The clinical value of electrocardiogram,X-ray chest film and CT in comprehensive diagnosis of chronic pulmonary heart disease

作　　者：陈正君[1] 刘勇[2] 宋震宇[2] 揭平平[2] 

机构地区：[1]泸州医学院附属医院物理诊断科,四川泸州646000 [2]泸州医学院附属中医院影像科,四川泸州646000

出　　处：《西部医学》2013年第3期456-458,共3页Medical Journal of West China

摘　　要：目的分析肺源性心脏病(PHD)的心电图、X线胸片与CT表现,探讨综合应用的临床价值。方法收集经临床确诊的肺心病27例,均作常规心电图、X线胸片、胸部CT平扫,其中17例行动态心电图检查,15例行CT增强扫描。对其心电图、胸片、CT资料进行回顾性分析。结果本组病例心电图以肺型P波为多(15例,55.6%),其次是QRS综合波改变、S-T段及T波变化、房室传导阻滞。X线胸片:心脏二尖瓣型22例,普大型5例;右心室增大19例,右心房增大6例,左心室增大4例。均见肺动脉段突出(≥0.3cm),右下肺动脉干增粗(≥1.5cm);肺门截断征21例。慢性支气管炎表现21例,肺气肿征象17例,2例合并支气管扩张。CT表现:大部分病例心脏增大,右心室增大或肥厚21例,右心房增大9例,左心室增大5例。右下肺动脉干增粗,外围动脉变细、扭曲、紊乱。慢性支气管炎表现23例,肺气肿15例,肺大泡11例,5例合并支气管扩张。心电图提示肺心病表现15例(55.6%),X线胸片诊断肺心病19例(70.3%),CT诊断肺心病22例(81.5%),三者综合诊断24例(88.9%)。结论心电图、X线胸片与CT对肺心病诊断都能提供一定的依据,三者综合应用可提高诊断率,临床应用价值更大。Objective To analyze the chronic pulmonary heart disease （PHD） electrocardiogram, X-ray chest film and CT performances and discuss the value of comprehensive application. Methods 27 cases of PHD for the routine electrocardiogram, X-ray chest film, and chest CT were analyzed, including 17cases with dynamic electrocardiogram and 15 cases with contrast enhanced CT scanning. Results There were 15 cases （55.6%）with pulmonary type P wave, followed by comprehensive QRS wave change, S-T section and T wave change and artioventricular block. There were 22 cases with heart mitral valce type, 5 cases with general large, 19 cases with right ventricle large, 6 cases with right atrium increase and 4 cases with left ventricle increase. ALL cases could see the pulmonary segment was prominent. 21 cases could see hilar truncation signs. There were 21 cases with heart increase, right ventricle increase or hypertrophy, 9 cases with right atrium increase and 5 cases with left ventricle increase. Pulmonary segment was thicken, peripheral artery necked, twisted and disorder. Conclusion Electrocardiogram, X-ray chest and CT diagnosis of PHD can provide a certain basis, comprehensive three methods diagnosis. Three comprehensive application can improve the diagnosisrate, and have more clinical application value.

关 键 词：肺心病 心电图 X线胸片 胸部CT 

分 类 号：R541.5[医药卫生—心血管疾病]