尘肺病合并肺部感染者的心电图特征

目的探讨尘肺病合并肺部感染者的心电图特征并分析其临床应用价值。方法选择本院2011年9月至2013年9月收治的150例尘肺病合并肺部感染者作为观察组,另选200例尘肺病无肺部感染者作为对照组,回顾性分析两组患者12导联常规心电图资料。结果观察组患者中共133例（88.7%）,对照组患者中共110例（55.0%）检出心电图异常。观察组患者心电图异常发生率居前3位依次为窦性心动过速（62.0%）〉房性期前收缩（44.7%）〉房性心动过速（25.3%）。对照组由高到低依次为房性期前收缩（18.5%）〉房室传导阻滞（14.5%）〉窦性心动过速（8.5%）。观察组患者心电图异常发生情况居前3位依次为HR〉120 bpm（85.8%）、V1 R/S≥1并V5 R/S≤1（67.3%）、肢导联P波≥0.22 m V（65.5%）,对照组依次为肢导联P波≥0.22 m V（62.7%）、V1 R/S≥1并V5R/S≤1（52.7%）、直立部分高度（PV1双向波直立尖角）〉0.07 m V（47.3%）。观察组患者以细菌感染（71.3%）为主,其中,革兰阴性杆菌感染（20.5%）最高,其余依次为产超光谱β-内酰胺酶（ESBLs）大肠埃希菌（19.4%）、耐甲氧西林金黄色葡萄球菌（MRSA）（15.7%）和铜绿假单胞菌及肺炎链球菌（12.0%）。结论密切观察尘肺病患者的心电图改变,有助于对患者肺部感染的早期诊断、病情评估和及时治疗。

The electrocardiogram characteristics of nosocomial infection in patients with pneumoconiosis

Objective To investigate the electrocardiogram（ECG） characteristic of pneumoconiosis patients with pulmonary infection and to analyze its clinical value. Methods Total of 150 cases of pneumoconiosis patients with pulmonary infection were collected as the observation group, while 200 cases of pneumoconiosis patients without lung infection were collected as the control group. The 12-lead ECG data of two groups were analyzed, retrospectively. Results There were 133（88.7%） patients in observation group and 110（55.0%） patients in control group detected abnormal ECG. The incidence of the top three ECG abnormalities in observation group were sinus tachycardia（62.0%） 〉atrial contraction（44.7%）〉 atrial tachycardia（25.3%）, and those in control group were atrial contraction（18.5%） 〉atrioventricular block（14.5%）〉 sinus tachycardia（8.5%）. The top three ECG abnormalities occurred in patients in the observation group were HR 〉120 bpm（85.8%）, V1 R/S ≥ 1 and V5 R/S ≤ 1（67.3%）, limb lead P wave ≥ 0.22 m V（65.5%） and in the control group were limb lead P wave ≥ 0.22 m V（62.7%）, V1 R/S ≥ 1 and V5 R/S ≤ 1（52.7%）, the height of the upright portion（PV1 bi-wave vertical corners） 〉0.07 m V（47.3%）. Bacterial infections（71.3%） dominated in all infections, in which Gram-negative bacilli infections（20.5%） was the highest, followed by extended spectrum β-lactamases（ESBLs）-producing E. coli（19.4%）, methicillinresistant Staphylococcus aureus（MRSA）（15.7%）, Pseudomonas aeruginosa and Streptococcus pneumoniae（12.0%）. Conclusion Closely observation of the ECG changes in pneumoconiosis patients contributes to early diagnosis, assessment and timely treatment of pulmonary infections.