慢性阻塞性肺疾病急性加重期心电图特点分析

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)心电图特点,指导临床诊治。方法选取AECOPD患者124例作为AECOPD组,无明显症状体征的患者131例作为对照组,应用l~2导联同步动态心电记录仪记录心电信息,由心电图室专科医师进行心律失常分析、心率变异度检测及心功能分级,比较两组的差别。结果两组缓慢性心律失常发生率及分类比较,差异无统计学意义(P0.05);快速性心律失常发生率及构成之间,心律失常检出率与严重心律失常发生率,室上性、室性心律失常发生率的分类比较中,差异均有统计学意义(P0.05),AECOPD组较对照组高;两组ST-T改变差异有统计学意义(P0.05),AECOPD组较对照组更加广泛;AECOPD组患者HRV各域值均较对照组明显下降,其心衰患者SDNN平均值为(50±12)ms,显著低于其他心功能级别者,差异均有统计学意义(P0.05)。结论 AECOPD患者心律失常以快速性为主,其严重及恶性心律失常发生率高,ST-T改变广泛而显著,迷走神经功能减退,SDNN50ms可辅助心衰的诊断。

Analysis of electrocardiogram characteristics in patients with AECOPD

Objective To explore the electrocardiogram characteristics of AECOPD and to provide guidance for clinical diagnosis and treatment. Methods 124 AECOPD patients were taken as the AECOPD group,and 131 cases who had no obvious symptoms and signs were selected as the control group. It used 12 lead synchronous dynam-ic ECG recorder to record the ECG information,and analyzed by the electrocardiogram room specialists. The heart rate variability and the classification of cardiac function were monitored too. The differences were compared between the two groups. Results The differences of arrhythmia incidence and classification between the two groups were not statistically significant(P > 0. 05). There were significant difference in the rapid arrhythmia rate,the detection rate of arrhythmia occurrence and serious arrhythmia,the incidence of classification of supraventricular and ventricular ar-rhythmias between the two groups,and they were higher in the AECOPD group than in the control group(P < 0. 05). The change of ST-T was more significant in the AECOPD group than in the control group(P < 0. 05). The value of HRV in each domain were significantly decreased in the AECOPD group compared with the control group( P <0. 05). In the AECOPD group,the average of SDNN in the heart failure patients was(50 ± 12)ms,significantly lower than the other grade of heart function(P < 0. 05). Conclusion Arrhythmia in AECOPD patients is rapid,the incidence of serious arrhythmia and malignant arrhythmia are significantly higher than in the control group. The ST-T changes are widely and significantly,the vagus nerve of AECOPD patients is dysfunction,and the SDNN < 50ms may assist the diagnosis of heart failure.