慢性肺源性心脏病并发心律失常临床分析

目的：对慢性肺源性心脏病并发心律失常的临床特征、发作类型和病因进行观察分析。方法收集开封市中心医院2009年5月至2013年5月收治的慢性肺源性心脏病患者193例进行24 h 心电监护或反复常规12导联心电图检查。发现并发心律失常120例，未并发心律失常73例，对所有患者进行常规治疗，观察心律失常类型和并发症发生情况。结果在193例慢性肺源性心脏病患者中有120例并发心律失常，其中窦性心动过速52例，房室早搏26例，房性心动过速11例，心房颤动10例，室性早搏 6例，右束支传导阻滞4例，左束支传导阻滞3例，房室传导阻滞3例，心房扑动5例；心律失常患者并发肺部感染、心力衰竭、低氧血症、电解质紊乱及酸碱平衡失调发生率均高于未并发心律失常患者，差异有统计学意义（P 〈0.05）。结论慢性肺源性心脏病并发心律失常比例较高，以窦性心律过速和房室早搏较多，其常见诱因为肺部感染、低氧血症、心力衰竭、电解质紊乱等，给予相应治疗可有效降低慢性肺源性心脏病并发心率失常发生率。

Clinical analysis of chronic pulmonary heart disease complicated with arrhythmia

Objective To observe the clinical features,types and pathogenesis of patients with chronic pulmonary heart disease complicated with arrhythmia. Methods One hundred and ninety-three patients with chronic pulmonary heart disease were enrolled from May 2009 to May 2013. 24 h ECG mo-nitor and repeated 12 - lead ambulatory electrocardiogram were carried out. One hundred and twenty pa-tients complicating arrhythmia were found. All patients underwent conventional treatment,and types and complications of arrhythmia were investigated. Results Among the 193 patients,120 cases were compli-cated with arrhythmia,and there were 52 cases of Sinus tachycardia, 26 cases of atrial premature contraction,11 cases of atrial tachy-cardia,10 cases of atrial fibrillation,6 cases of ventricular premature contraction,4 cases of right bundle branch block,3 cases of left bundle branch block,3 cases of atrioventricular block,5 cases of atrial flut-ter. The incidence of pulmonary infection,heart failure,hypoxemia,electrolyte imbalance and acid-base disorders were higher in arrhythmia patients than that in patients without arrhythmia（P 〈 0. 05）. Con-clusions There is high proportion of patients with chronic pulmonary heart disease complicated with ar-rhythmia,such as sinus tachycardia and atrial/ ventricular premature contraction. Lung infections,hypox-ia,heart failure and electrolyte imbalance are common inducing factors,therefore,chronic pulmonary heart disease complicated with arrhythmia may be ameliorated under appropriate treatment.