冠心病患者心功能与肺动脉压、心电指标的关系

【摘要】 目的 研究冠心病患者的心功能和肺动脉压力（Pulmonary arterial pressure，PAP）、心电指标之间的关系。方法 入选2009年10月到2010年5月在我院住院的冠心病患者113例,按照NYHA分级分为A组（Ⅰ、Ⅱ级）、B组（Ⅲ级）、C组（Ⅳ级），比较三组之间的PAP、P波离散度(P dispersion，Pd)、QT间期（QT）、QT离散度（QT dispersion，QTd）、T波峰-末间期（Tpeak-Tend，Tp-e）和经纠正后的QT（QTc）、QTd（QTcd）、Tp-e（Tp-e/RR ）之间的差异。结果 三组之间的PAP、Pd、QT/QTc、QTd/QTcd、Tp-e、Tp-e/RR 有显著性差异（p<0.05），并且随着心功能的恶化（B组对A组，C组对B组），PAP逐渐升高，Pd、QT/QTc、QTd/QTcd、Tp-e、Tp-e/RR 逐渐增加，差异具有统计学意义（p<0.05）。结论 冠心病患者随着心功能的恶化，PAP有升高的趋势，Pd、QT/QTc、QTd/QTcd、Tp-e、Tp-e/RR 有增加的趋势，发生房颤和恶性心律失常的风险增加。

The Relationship between Heart Function, Pulmonary Arterial Pressure and ECG Indices in Patients with Coronary Heart Disease

Abstract Objective: To study the relationship between heart function and pulmonary arterial pressure (PAP), ECG indices in patients in coronary heart disease(CHD). Methods: According to NYHA classification,113 patients who were inpatiented in our hospital were classified with A group(Ⅰ、Ⅱ), B group(Ⅲ), C group(Ⅳ), compare PAP, P dispersion(Pd), QT interval(QT), QT dispersion(QTd), Tpeak-Tend interval(Tp-e) and corrected QT(QTc), corrected QTd(QTcd), corrected Tp-e( Tp-e/RR ) among three groups. Results: There were significant differences in PAP, Pd, QT/QTc, QTd/QTcd, Tp-e, Tp-e/RR among three groups(p<0.05), and with the deterioration of heart function(B group vs A group,C group vs B group), all of this ECG indices including Pd, QTd/QTcd, Tp-e, Tp-e/RR are increaseing gradually, PAP is increaseing gradually,the difference is significant(p<0.05). Conclusion: With the deterioration of heart function in CHD patients, all of this ECG indices, including Pd, QTd/QTcd, Tp-e, Tp-e/RR and PAP enhanced, the patients with heart failure are more likely to suffer from atial fibrillation and malignant cardiac arrhythmia.