心电图和超声心动图检查对煤工尘肺并发肺心病患者的诊断和治疗的价值  

Value of ECG and echocardiography in diagnosis and treatment of CWP patients with pulmonary heart disease

作　　者：王丽丽[1] 

机构地区：[1]国家安全生产监督管理总局职业安全卫生研究中心,北京市102308

出　　处：《职业与健康》2015年第7期895-899,共5页Occupation and Health

摘　　要：目的探讨心电图及超声心动图检查在尘肺并发肺心病患者的诊断、治疗以及病情观察中的重要性。方法收集国家安全生产监督管理总局职业安全卫生研究中心2013年住院的89例煤工尘肺患者作为尘肺组,同时选择从事煤矿井下作业无尘肺病诊断的退休工人60名作为对照组,全部为男性,尘肺组与对照组年龄及接尘时间无显著性差异,同时排除其他心脏疾患。将尘肺组及对照组同时进行心电图及超声心动图检查并进行统计学分析。结果尘肺组和对照组心电图肺心病检出率分别为27.0%和11.7%,差异有统计学意义(χ2=5.091,P<0.05)。尘肺组不同期别煤工尘肺心电图肺心病检出率分别为Ⅰ期16.7%、Ⅱ期30.0%、Ⅲ期34.5%。尘肺组和对照组的超声心动图肺心病检出率分别为48.3%、23.3%,差异有统计学意义(χ2=9.469,P<0.01)。尘肺组不同期别煤工尘肺超声心动图肺心病检出率分别为Ⅰ期30.0%、Ⅱ期43.3%、Ⅲ期72.4%。尘肺组心电图及超声心电图肺心病检出率分别为27.0%和48.3%,差异有统计学意义(χ2=8.640,P<0.01)。超声心动图右心室流出道增宽诊断煤工尘肺患者肺心病患病率优于右心室增大及左/右心室减小,差异有统计学意义(χ2=10.687,P<0.01)。结论超声心动图对于尘肺并发肺心病患者的诊断、治疗以及病情观察比心电图检查更具有优越性。煤工尘肺对心血管系统的影响比较显著,应用超声心动图检查能够早期发现尘肺患者的肺心病并发症,及时采取治疗措施,对延缓其病情快速发展,改善患者预后均有非常重要的意义。[Objective]To investigate the value of ECG and echocardiography in diagnosis, treatment and observation of CWP patients with pulmonary heart disease.[nethods]A total of 89 CWP inpatients in Occupational Safety and Health Research Center of State Administration of Work Safety in 2013 were selected as observation group, another 60 retired workers, who had been engaged in the coal mine operations without CWP were selected as control group, all were male. No significant differences of age and service length were observed between observation group and control group, and they had no other cardiac diseases. ECG and echocardiography was performed on both groups, and the results were analyzed statistically. [Results]The detection rate of pulmonary heart disease in observation group and control group was 27.0% and 11.7%, respectively, with significant difference （x^2=9.469, P〈0.01 ）. The detection rate of pulmonary heart disease of CWP patients at stage I, II, III was 30.0%, 43.3% and 72.4%, respectively via echocardiography. The detection rate of pulmonary heart disease of control group was 27.0% and 48.3% via ECG and echocardiography, with significant difference （x^2=8.640, P〈0.01）. By using echocardiography, detection of pulmonary heart disease via echocardiography enlargement of the right ventricular outflow tract was better than that via enlargement of the right ventricle and left/right ventricle diminution, with significant difference （x^2=10.687, P〈0.01）. [Conclusion]Echocardiography is superior to ECG in diagnosis, treatment and observation of CWP patients with pulmonary heart disease. CWP has significant effect on cardiovascular system. Echocardiography can detect CWP complications of pulmonary heart disease early, therefore, it has significance in delaying the rapid development of the disease and improving the prognosis through timely adoption of treatment measures.

关 键 词：煤工尘肺患者 肺心病 心电图 超声心动图 

分 类 号：R135.2[医药卫生—劳动卫生]