【摘要】：目的:通過觀察慢性阻塞性肺疾病患者心電圖額面P波電軸(?P)水平,以及分析其分別與體重指數(shù)(BMI)、殘總比(RV/TLC)、吸氣分?jǐn)?shù)(IC/TLC)、第一秒用力呼氣容積占預(yù)計(jì)值百分比(FEVI%pred)、MMRC評分指數(shù)、CAT評分相關(guān)性、COPD綜合評估的關(guān)系,探討?P在COPD患者診斷篩查、病情嚴(yán)重程度和預(yù)后評估中臨床應(yīng)用價(jià)值。方法:選擇2016年07月至2017年01月在昌吉州人民醫(yī)院內(nèi)科門診就診或住院的慢性阻塞性肺疾病患者107名(男85例,女22例,年齡為63.70±9.26)為試驗(yàn)組,同期在門診體檢并與入選研究組性別、年齡相匹配健康人107名(男性85名,女性22名,平均年齡為62.27±8.75歲)為對照組。對試驗(yàn)組和對照組受試者測得身高、體重,行心電圖及肺功能檢查,對107例COPD受試者行改良的英國醫(yī)學(xué)會研究委員會呼吸困難量表(MMRC)評分、慢性阻塞肺疾病評估測試(CAT)評分,依據(jù)COPD綜合評估把試驗(yàn)組107名COPD患者分為4級:A級、B級、C級、D級;各組數(shù)據(jù)用SPSSl7.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,比較額面P電軸在慢性阻塞肺疾病試驗(yàn)組與正常對照組間,A、B、C、D4級間差別,并分析額面P波電軸分別與體重指數(shù)(BMI)、吸氣分?jǐn)?shù)(IC/TLC)、殘總比(RV/TLC)、第一秒用力呼氣容積占預(yù)計(jì)值百分比(FEVI%pred)、MMRC評分指數(shù)、CAT生活質(zhì)量評分相關(guān)性。結(jié)果:1.慢性阻塞性肺疾病患者額面P波電軸顯著大于正常對照組(P0.05);2.額面P電軸與BMI呈負(fù)相關(guān)(r=-0.203,P0.05)、與RV/TLC呈正相關(guān)(r=0.451,P0.01)、與IC/TLC呈負(fù)相關(guān)(r=-0.503,P0.01)、與FEVl%pmd呈負(fù)相關(guān)(r=-0.352,P0.01)、與mMRC評分呈正相關(guān)(r=0.432,P0.01)、與CAT評分呈正相關(guān)(r=0.405,P0.01)。3.COPD患者綜合評估分級各級?P的比較:D級額面P電軸明顯高于A級(P0.01)、B和C級(P0.05),A級額面P電軸低于B、C兩級(P0.05),余不同級別間無統(tǒng)計(jì)學(xué)差異。結(jié)論:1.額面P波電軸垂直化在慢性阻塞性肺疾病診斷方面的敏感性、特異性均較高,有一定臨床應(yīng)用價(jià)值,并可用于評估其嚴(yán)重程度。
[Abstract]:Objective: to observe the level of P wave axis (? P) in frontal surface of patients with chronic obstructive pulmonary disease (COPD), and to analyze its correlation with body mass index (BMI),) residual total ratio (RV/TLC), inspiratory fraction (IC/TLC), body mass index (BMI), total residual ratio (RV/TLC) and inspiratory fraction (IC/TLC). The percentage of forced expiratory volume in the first second (FEVI%pred), MMRC score, CAT score correlation, COPD comprehensive evaluation), to explore the clinical value of P in the diagnosis and screening, severity and prognosis evaluation of COPD patients. Methods: 107 patients with chronic obstructive pulmonary disease (85 males, 22 females, age 63.70 鹵9.26) were selected as experimental group. 107 healthy subjects (85 males and 22 females, with an average age of 62.27 鹵8.75 years) were matched with the sex and age of the study group at the same time. Height, weight, electrocardiogram and pulmonary function were measured in the test group and the control group, and (MMRC) scores of the modified BMA Respiratory dyspnea scale were performed on 107 subjects with COPD. According to the (CAT) score of chronic obstructive pulmonary disease evaluation test, 107 COPD patients in the trial group were divided into four grades: grade A, grade B, grade C and grade D according to the comprehensive evaluation of COPD. The data of each group were statistically analyzed by SPSSl7.0 software. The differences of frontal P axis and body mass index (BMI),) were compared between the chronic obstructive pulmonary disease test group and the normal control group, and the frontal P wave axis was compared with the body mass index (BMI),). Inspiratory fraction (IC/TLC), total residual ratio (RV/TLC), forced expiratory volume in the first second as a percentage of predicted value (FEVI%pred), MMRC score, CAT quality of life score) were correlated. Results: 1. P wave axis of frontal surface in patients with chronic obstructive pulmonary disease was significantly higher than that in normal control group (P0.05). There was a negative correlation between frontal P axis and BMI (P 0.05), positive correlation with RV/TLC (r P 0.01), negative correlation between P axis and IC/TLC (r P 0.01), and negative correlation between P axis and FEVl%pmd. There was a positive correlation with the mMRC score (r = 0.432P 0.01) and a positive correlation with the CAT score (r = 0.405, P < 0.05). Comparison of 3.COPD patients' comprehensive evaluation grade? P: grade D frontal P axis was significantly higher than A grade (P0.01), B and C grade (P0.05), A frontal P axis was lower than), A C grade (P0.05). There was no statistical difference between different grades. Conclusion: 1. The sensitivity and specificity of frontal P wave axis perpendicularity in the diagnosis of chronic obstructive pulmonary disease (COPD) is high. It has certain clinical application value and can be used to evaluate its severity.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R563.9

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