慢性阻塞性肺疾病合并心血管疾病的心电图特征分析  

Electrocardiogram characteristics of patients with chronic obstructive pulmonary disease in combination with cardiovascular diseases

作　　者：蔡晓莲 龙舟 刘禹 赖富华[3] 郭宇航 李瑾 唐咸军 胥洪燕 陈华萍 张明周 Cai Xiaolian;Long Zhou;Liu Yu;Lai Fuhua;Guo Yuhang;Li Jin;Tang Xianjun;Xu Hongyan;Chen Huaping;Zhang Mingzhou(Cardiovascular Department,Southwest Hospital,Army Military Medical University,Chongqing 400038,China;Institute of Respiratory Diseases,Xinqiao Hospital,Army Military Medical University,Chongqing 400037,China;Department of Respiratory Medicine,Fifth People′s Hospital,Chongqing 400062,China;Department of Clinical Laboratory,Orthopaedic Hospital of Traditional Chinese Medicine,Chongqing 400012,China)

机构地区：[1]陆军军医大学(第三军医大学)第一附属医院心血管内科,重庆140003 [2]陆军军医大学(第三军医大学)第二附属医院全军呼吸内科研究所,重庆240006 [3]重庆市第五人民医院呼吸内科,重庆340001 [4]重庆市中医骨科医院检验科,重庆400012

出　　处：《中华肺部疾病杂志（电子版）》2019年第6期682-686,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家科技部重点研发计划课题(2016YFC1304503)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)合并心血管疾病的影响因素及心电图特征。方法回顾性分析入住的急性期慢阻肺患者124例,按照是否合并有心血管疾病(cardiovascular diseases,CVD)分为无心血管疾病的COPD组24例和合并心血管疾病的COPD组100例;同时,再将合并心血管疾病组分为冠心病33例、肺心病36例、心律失常31例三个亚组,分析每组相关危险因素及心电图异常特征。结果对照组与合并CVD组患者在性别比例、年龄、吸烟史方面均无统计学差异(P>0.05),但合并肺心病组在病程和吸烟时间上显著高于对照组(P<0.05)。在影响因素分析中发现,COPD合并CVD后出现感染、高血脂、高血糖比例以及吸烟时间显著高于对照组(P<0.05)。在心电图结果分析中,显示100例合并心血管疾病的COPD患者中,57例(57.00%)患者心电图检查出现异常;在合并冠心病、肺心病以及心律失常三个亚组中,心电图异常的发病率分别为房性早搏(27.27%、30.55%、45.16)、右束支传导阻滞(21.21%、23.15%、29.03%)、肢体导联低电压(18.18%、19.44%、19.35%)、心电轴右偏(9.09%、30.55%、45.16%%)、肺型P波(3.03%、16.66%、3.22%)、顺钟向转位(0、5.62%、6.44%);其次COPD合并心血管疾病的患者出现心电图异常的比例高于对照组(P<0.05),在合并肺心病组和心律失常组心电图异常比例升高尤为显著(P<0.05)。结论COPD患者合并CVD发生率较高,而吸烟时间、感染、高血脂、高血糖与其密切相关,结合患者心电图特征性改变,可对COPD合并CVD早期诊治提供参考。Objective To explore the influence factors and electrocardiographic characteristics of the patients with chronic obstructive pulmonary disease(COPD)in combination with cardiovascular diseases(CVD).Methods The data of 124 hospitalized patients with acute COPD were retrospectively analyzed in this study.According to whether they had cardiovascular disease,the patients were divided into two groups:the COPD group without cardiovascular disease(the control group,n=24)and the COPD group with cardiovascular disease(CVD,n=100).Meanwhile,the patients combined with cardiovascular disease were divided into three subgroups:the coronary heart disease group(n=33),the pulmonary heart disease group(n=36)and the arrhythmia group(n=31).The influence factors and electrocardiogram abnormalities were analyzed in each group.Results There was no statistical significant difference in the sex ratio,age,course of disease,or smoking history between the control group and the CVD group(P>0.05),but the smoking time and the disease course of COPD in the CVD group were significantly higher than those of the control group(n<0.05).Analysis of risk factors found that the incidences of infection,hyperlipidemia,hyperglycemia and smoking time in the patients with COPD combined with CVD were significantly higher than those of the control group(n<0.05).The ECG analysis indicated that 57 out of 100 patients(57.00%)with COPD combined with CVD had abnormal ECGs.The incidences of atrial premature beats were respectively 27.27%,30.55%,and 45.16%,the incidences of right bundle branch block were respectively 21.21%,23.15%,and 29.03%,the incidences of limb lead low voltage were respectively 18.18%,19.44%,and 19.35%,the incidences of right axis deviation were respectively 9.09%,30.55%,and 45.16%,the incidences of pulmonary P wave were respectively 3.03%,16.66%,and 3.22%,and the incidences of clockwise transposition were respectively 0,5.62%,and 6.44%in the patients with COPD combined with coronary heart disease,pulmonary heart disease and arrhythmia.Furthermore

关 键 词：肺疾病 慢性阻塞性 心血管疾病 心电图 影响因素 

分 类 号：R563[医药卫生—呼吸系统]