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[1]欧敏,王斌,张明周,等.心电图及心脏超声在急性肺栓塞诊断及危险分层中的意义[J].中华肺部疾病杂志,2022,(04):502-505.[doi:10.3877/cma.j.issn.1674-6902.2022.04.011]
　Ou Min,Wang Bin,Zhang Mingzhou,et al.Significance of electrocardiogram and echocardiography in the diagnosis of acute pulmonary embolism and risk stratification[J].,2022,(04):502-505.[doi:10.3877/cma.j.issn.1674-6902.2022.04.011]
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心电图及心脏超声在急性肺栓塞诊断及危险分层中的意义(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2022年04期
页码:
502-505
栏目:
出版日期:
2022-08-20

文章信息/Info

Title:
Significance of electrocardiogram and echocardiography in the diagnosis of acute pulmonary embolism and risk stratification
作者:
欧敏1; 王斌2; 张明周2; 董俊康2; 刘禹2; 廖品亮1; 任合玲1; 姜欣1; 蔡晓莲1
400038 重庆,陆军(第三)军医大学第一附属医院心血管内科1 400037 重庆,陆军(第三)军医大学第二附属医院全军呼吸内科研究所2
Author(s):
Ou Min1;  Wang Bin2;  Zhang Mingzhou2;  Dong Junkang2;  Liu Yu2;  Liao Pinliang1;  Ren Heling1;  Jiang Xin1;  Cai Xiaolian1.
1Cardiovascular Department, Southwest Hospital, Army Military Medical University, Chongqing 400038, China; 2Institute of Respiratory Disease, Xinqiao Hospital, Army Military Medical University Chongqing 400037, China
关键词:
急性肺栓塞;  心电图;  心脏超声;  危险分层
Keywords:
Acute pulmonary embolism;  Electrocardiogram;  Echocardiography;  Risk stratification
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2022.04.011
摘要:
目的 分析心电图及心脏超声在急性肺栓塞(APE)诊断及危险分层中的意义。方法 选择2018年1月至2021年1月对我院经肺动脉造影(CTA)确诊的肺栓塞患者120例,其中低危34例,中危70例,高危16例,根据危险分层及临床治疗需要分为中高风险组86例,低风险组34例。分析两组心电图及心脏超声。结果 中高风险组与低风险组性别比例、年龄等基线资料无统计学差异(P>0.05)。心电图显示:中高风险与低风险组间比较,心电图异常的发生率分别为窦性心动过速31例(36.05%)、3例(8.82%),房性心律失常13例(15.12%),肺性P波1例(1.16%),电轴右偏9例(10.47%)、3例(8.82%),右束支阻滞11例(12.79%)、3例(8.82%),SⅠQⅢTⅢ 24例(27.91%),肢体导联低电压7例(8.14%),胸前导联T波倒置15例(17.44%)。中高风险组窦性心动过速及房性心律失常的发生率较低风险组显著升高(P<0.05); 心脏超声:中高风险与低风险组间比较,右房内径(38.34±6.52、32.44±4.31)mm,右室内径(21.66±4.35、18.76±1.48)mm,左房内径(33.36±4.46、32.71±4.78)mm,左室内径(43.53±4.88、46.24±4.04)mm,射血分数(61.37±7.25%、62.32±5.28%),三尖瓣返流75例(87.21%)、24例(70.59%),肺动脉收缩压增高28例(32.56%)、4例(11.76%),中高风险组在右房内径、右室内径、三尖瓣返流及肺动脉高压的发生率较低风险组显著升高(P<0.05)。结论 APE心电图及心脏超声有特征性改变,两者在APE的诊断及危险分层中具有临床意义。
Abstract:
Objective To investigate the clinical significance of Electrocardiogram(ECG)and ecocardiography in the diagnosis of acute pulmonary embolism and risk stratification. Methods The ECG and echocardiographyof 120 patients of pulmonary embolism that were confirmed by CTA from January 2018 to January 2021 and divided into low risk 34 cases, middle risk 70 cases and high risk 16 cases groups, according to risk stratification of APE. The middle risk and high risk APE patients were affiliated to the Medium-high risk team 86 cases, and the low risk APE patients were affiliated to the low-risk team 34 cases according to emergent preliminary assessment. Results There was no statistical significant difference in the sex ratio, age and equal baseline data between the Medium-high risk team and the lowrisk team(P>0.05). Comparison of the Medium-high risk and low risk groups on the ECG: The incidences of sinus tachycardia were respectively 31 cases(36.05%), 3 cases(8.82%), the incidences of atrial arrhythmia were respectively 13 cases(15.12%), the incidences of pulmonary P wave were respectively 1 case(1.16%), the incidences of right axis deviation were respectively 9 cases(10.47%), 3 cases(8.82%), the incidences of right bundle branch block were respectively 11 cases(12.79%), 3cases(8.82%), the incidences of SⅠQⅢTⅢ were respectively 24 cases(27.91%), 4 cases(11.76%), the incidences of limb lead low voltage were respectively 7 cases(8.14%), the incidences of T-wave inversion were respectively 15 cases(17.44%). The incidences of sinus tachycardia, atrial arrhythmia were significantly higher in Medium-high groups than in low risk groups(P<0.05). Comparison of the Medium-high risk and low risk groups on the echocardiography: internal diameter of the right atrium(38.34±6.52,32.44±4.31)mm, internal diameter of the right ventricle(21.66±4.35,18.76±1.48)mm, internal diameter of the left atrium(33.36±4.46, 32.71±4.78)mm, internal diameter of the left ventricle(43.53±4.88,46.24±4.04)mm, left ventricular ejection fraction(61.37±7.25%, 62.32±5.28%), the incidences of tricuspid regurgitation were respectively 75 cases(87.21%), 24 cases(70.59%), the incidences of pulmonary artery systolic pressure were respectively 28 cases(32.56%), 4 cases(11.76%), The incidences of internal diameter of the right atrium, internal diameter of the right ventricle, tricuspid regurgitation and pulmonary artery hypertension were significantly higher in Medium-high groups than in low risk groups(P<0.05). Conclusion Most acute pulmonary embolismpatients have electrocardiograph and echocardiography changes. The two and their combination have important clinical significance in the diagnosis and risk stratification of pulmonary embolism.

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备注/Memo

备注/Memo:
基金项目: 国家科技部重点研发计划项目(2016YFC1304503)
通信作者: 蔡晓莲, Email: caixl2012@163.com，王斌，Email: wangbin985@126.com
更新日期/Last Update: 2022-08-20