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[慢性阻塞性肺疾病的心电图变化]

[Electrocardiographic changes in chronic obstructive lung diseases].

作者信息

Kes P, Strumberger I, Reiner Z

出版信息

Z Gesamte Inn Med. 1982 Dec;37(23):796-801.

PMID:6219503
Abstract

Various patterns and frequency of electrocardiographic changes in patients with chronic obstructive lung disease (COLD), as well as their relationship to the degrees of air-flow obstruction, were investigated. Electrocardiograms and pulmonary function tests were analysed in 302 patients (230 men and 72 women) with COLD, and the results were compared with the results of the same examinations obtained in 86 healthy subjects (63 men and 23 women). The most common electrocardiographic patterns were: a) "P pulmonale", b) right axis' deviation of the P wave, and right axis' deviation of the QRS complex, c) inversion of the T waves in standard (II and III) and in the precordial leads (V1 to V4), d) the presence of a qR pattern with delayed R wave in V1 (V5R) (onset of intrinsicoid deflection more than 0,003 seconds) which was often associated with an incomplete right bundle branch block.--P pulmonale and inversion of the T waves in standard and precordial leads were considered as labile, reversible electrocardiographic changes which do not show any correlation with the severity of COLD. Deviations of the P wave and QRS complex to the right, significantly correlated with the degree of the air-flow obstruction (P less than 0,05) in patients with COLD, but the changes are not sure signs of chronic cor pulmonale. On the contrary, qR pattern with delayed R wave in V1 (V5R) (onset of intrinsicoid deflection more than 0,03 seconds), which was often associated with an incomplete right bundle branch block, was significantly correlated (P less than 0,001) with the degree of air-flow obstruction in patients with COLD and may be considered as highly suggestive for the diagnosis of chronic cor pulmonale.

摘要

对慢性阻塞性肺疾病(COLD)患者心电图变化的各种模式和频率及其与气流阻塞程度的关系进行了研究。对302例COLD患者(230例男性和72例女性)的心电图和肺功能测试进行了分析,并将结果与86例健康受试者(63例男性和23例女性)相同检查的结果进行了比较。最常见的心电图模式为:a)“肺型P波”;b)P波电轴右偏及QRS波群电轴右偏;c)标准导联(II和III)及胸前导联(V1至V4)T波倒置;d)V1导联出现qR型且R波延迟(V5R)(类本位曲折起始超过0.03秒),常伴有不完全性右束支传导阻滞。——肺型P波以及标准导联和胸前导联T波倒置被认为是不稳定、可逆的心电图变化,与COLD的严重程度无任何相关性。COLD患者中,P波和QRS波群向右偏移与气流阻塞程度显著相关(P<0.05),但这些变化并非慢性肺源性心脏病的确诊体征。相反,V1导联出现qR型且R波延迟(V5R)(类本位曲折起始超过0.03秒),常伴有不完全性右束支传导阻滞,与COLD患者的气流阻塞程度显著相关(P<0.001),可被视为慢性肺源性心脏病诊断的高度提示性表现。

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