本文選題：肺疾病 + 慢性阻塞性��； 參考：《遼寧醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的 探討立體心電向量圖對慢性阻塞性肺疾�。–OPD）肺動脈高壓引起的心臟結(jié)構(gòu)和血流動力學(xué)變化的診斷意義。 方法 93例COPD患者依心臟彩超分為三組：A組為無肺動脈高壓組34例（男15例，女19例），B組為肺動脈高壓組33例（男13例，女20例），C組為肺動脈高壓并右心室肥大組（男10例，女16例）26例。記錄立體心電向量圖，分析肺動脈壓升高和右心室肥大對QRS最大向量及心室復(fù)極梯度振幅、方位（仰角、方位角），空間QRS-T夾角、比值的影響；對B組進一步分析肺動脈壓升高與上述指標的關(guān)系。 結(jié)果 （1）QRS最大向量方位角、心室復(fù)極梯度方位角：B組（-62.20±57.01、-56.72±28.18）較A組（-23.54±32.97、-9.22±27.92）、C組（-135.74±26.03、-139.36±40.70）較B組（-62.20±57.01、-56.72±28.18）負值均增大，差異有顯著統(tǒng)計學(xué)意義（P＜0.01），QRS-T夾角B組較A組增大，差異有顯著統(tǒng)計學(xué)意義（P＜0.01）； （2）B組QRS-T夾角、心室復(fù)極梯度方位角均與肺動脈壓升高程度直線相關(guān)（r1=0.89，P1＜0.05；r2=-0.86，P2＜0.05）。 結(jié)論 （1）QRS最大向量、心室復(fù)極梯度方位角負值增大均有助COPD患者肺動脈高壓及肺動脈高壓并右心室肥大的識別； （2）在無右心室肥大時，，QRS-T夾角、心室復(fù)極梯度方位角的增加可反映肺動脈高壓的程度，隨著QRS-T夾角的增大、心室復(fù)極梯度方位角的減小，肺動脈高壓越明顯。
[Abstract]:Objective to investigate the diagnostic significance of stereoscopic electrocardiogram (STVG) in the changes of cardiac structure and hemodynamics in patients with pulmonary hypertension caused by chronic obstructive pulmonary disease (COPD). Methods 93 patients with COPD were divided into three groups according to color Doppler echocardiography: 34 cases (15 males, 19 females) without pulmonary hypertension in group A, 33 cases (13 males) in group B with pulmonary hypertension. Group C consisted of 26 patients with pulmonary hypertension and right ventricular hypertrophy (male 10, female 16). The effects of elevated pulmonary artery pressure and right ventricular hypertrophy on QRS maximum vector amplitude, azimuth (elevation, azimuth), spatial QRS-T angle and ratio were recorded. In group B, the relationship between pulmonary hypertension and the above indexes was further analyzed. Results (1) the maximum vector azimuth angle of QRS and the negative value of ventricular repolarization gradient azimuth angle in group B (-62.20 鹵57.01U -56.72 鹵28.18) were significantly higher than those in group C (-135.74 鹵26.03-139.36 鹵40.70) and group B (-62.20 鹵57.01) -56.72 鹵28.18 (P < 0.01). The difference was statistically significant (P < 0. 01); (2). The angle of QRS-T and the azimuth of ventricular repolarization gradient in group B were all correlated with the degree of pulmonary artery pressure elevation (R1: 0. 89, P1 < 0. 05, r2- 0. 86, P 2 < 0. 05). Conclusion (1) the maximum QRS vector and the negative azimuth of the ventricular repolarization gradient are helpful for the recognition of pulmonary hypertension and pulmonary hypertension associated with right ventricular hypertrophy in COPD patients, and (2) the QRS-T angle is found in the absence of right ventricular hypertrophy. The increase of ventricular repolarization gradient azimuth angle can reflect the degree of pulmonary hypertension. With the increase of QRS-T angle and the decrease of ventricular repolarization gradient azimuth angle, pulmonary hypertension becomes more obvious.
【學(xué)位授予單位】：遼寧醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.9

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相關(guān)期刊論文 前1條

1 ;慢性阻塞性肺疾病診治指南(2007年修訂版)[J];中華結(jié)核和呼吸雜志;2007年01期

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