摘要
目的探讨立体心电向量图对慢性阻塞性肺疾病(COPD)肺动脉高压的诊断意义。方法选择62例COPD患者依超声心动图分为无肺动脉高压组(A组)23例,肺动脉高压组(B组)22例,肺动脉高压并右心室肥大组(C组)17例。记录立体心电向量图,分析肺动脉压升高和右心室肥大对QRS最大向量及心室复极梯度振幅、方位,空间QRS-T夹角、比值的影响;对B组进一步分析肺动脉压升高与上述指标的关系。结果①QRS最大向量方位角、心室复极梯度方位角:B组较A组、C组较B组负值均增大,差异有显著统计学意义(p<0.01),QRS-T夹角B组较A组增大,差异有显著统计学意义(p<0.01);②B组QRS-T夹角、心室复极梯度方位角均与肺动脉压升高程度直线相关(r1=0.89,p1<0.05;r2=-0.86,p2<0.05)。结论立体心电向量图QRS最大向量方位角、QRS-T夹角、心室复极梯度方位角均有助COPD患者肺动脉高压及肺动脉高压并右心室肥大的识别。
Objective To study the ability of the three-dimensional vectorcardigram to detect diagnosis accuracy of pulmonary hypertension in chronic obstructive pulmonary disease.Methods Total 62 patients with Chronic Obstructive Pulmonary Disease were collected who had taken color doppler echocardiography,and they were divided into three groups,such as Group A,23 consecutive adults with normal pulmonary artery systolic pressure（PASP）,Group B,22 subjects with pulmonary hypertension and Group C,17 patients with pulmonary hypertension and RV hypertrophy.All patients were examed by the three-dimensional vectorcardiogram.Results ①Compared with group A,the maximum spatial QRS vector azimuth was higher in patients with group B（p〈0.01）,but less than those with group C（p〈0.01）.The ventricular gradient azimuth was also larger in patients with group B than those with group A（p〈0.01））,but less than those with group C（p〈0.01）.The spatial QRS-T angle was higher in patients with group B than those with group A（p〈0.01）;②In patients with pulmonary hypertension but not with RV hypertrophy（group B）,there was a linear correlation between the spatial QRS-T angle and the pulmonary artery systolic pressure（r1=0.89,p1〈0.05）,between the ventricular gradient azimuth and the pulmonary artery systolic pressure（r2=-0.86,p20.05）.Conclusion All of the spatial QRS-T angle,the ventricular gradient tazimuth and the maximum spatial QRS vector azimuth may be helpful to recognize Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease with or without RV hypertrophy.
出处
《临床心电学杂志》
2011年第6期418-421,共4页
Journal of Clinical Electrocardiology
关键词
肺疾病
慢性阻塞性
肺动脉高压
立体心电向量图
心电图
Pulmonary Chronic obstructive
Pulmonary arterial hypertension
Vectorcardiography
Electrocardiography
