肺源性心脏病患者肺部感染前后心电图及心肌酶的变化研究

Electrocardiogram and myocardial enzyme of patients with cor pulmonale before and after pulmonary infections

    摘要
  • 摘要: 目的 探讨肺源性心脏病患者肺部感染前后心电图及心肌酶的变化,为临床诊治提供参考。方法 选取2015年6月-2016年6月在医院诊治的肺源性心脏病并发肺部感染患者60例,均并发心律失常,在入院后给予抗感染治疗,感染未控制前不给予抗心律失常药物,对患者感染控制前(入院后感染确诊时)、感染控制后进行心电图及心肌酶检查。结果 感染控制前心电图检查显示,分别有41例房性早搏、26例房颤、31例窦性心动过速、32例窦性心动过缓、14例房室传导阻滞、27例束支传导阻滞、28例室性早搏,分别占68.33%、43.33%、51.67%、53.33%、23.33%、45.00%、46.67%,感染控制后心电图检查显示,分别有28例房性早搏、14例房颤、18例窦性心动过速、15例窦性心动过缓、6例房室传导阻滞、14例束支传导阻滞、16例室性早搏,分别占46.67%、23.33%、30.00%、25.00%、10.00%、23.33%、26.67%,感染控制前后比较差异有统计学意义(P＜0.05); 患者感染控制后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天门冬氨酸转氨酶(AST)水平低于感染控制前,感染控制前后比较差异有统计学意义(P＜0.05)。结论 肺源性心脏病并发肺部感染患者感染控制后,心律失常可得到一定程度改善,心肌酶水平可有一定程度降低。应积极预防和尽早控制肺部感染。

     

    Abstract: OBJECTIVE To explore the changes of electrocardiogram and myocardial enzyme of patients with cor pulmonale before and after pulmonary infections so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 60 cor pulmonale patients complicated with pulmonary infections who were treated in the hospital from Jun 2015 to Jun 2016 were enrolled in the study, all of whom were complicated with arrhythmia and were given anti-infection therapy after the admission, the antiarrhythmic drugs were not used until the infections were under control, and the electrocardiogram and myocardial enzyme examinations were carried out before (the infection was confirmed after the admission) and after the control of the infections.RESULTS Before the control of infections, the electrocardiogram examination indicated that there were 41 (68.33%) patients with atrial premature beat,26 (43.33%) patients with atrial fibrillation,31 (51.67%) patients with sinus tachycardias, 32 (53.33%) patients with sinus tachycardia,14 (23.33%) patients with atrioventricular blocks,27 (45.00%) patients with bundle branch block, and 28 (46.67%) patients with ventricular premature beat.After the control of infections, the electrocardiogram examination showed that there were 28 (46.67%) patients with atrial premature beat, 14 (23.33%) patients with atrial fibrillation, 18 (30.00%) patients with sinus tachycardias, 15 (25.00%) patients with sinus tachycardia, 6 (10.00%) patients with atrioventricular blocks, 14 (23.33%) patients with bundle branch block, and 16 (26.67%) patients with ventricular premature beat; there was significant difference before and after the control of infections (P＜0.05).The levels of creatine kinase (CK), creatine kinase isoenzymes(CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) were lower after the control of infections than before the control of infection(P＜0.05).CONCLUSIONThe arrhythmia of the cor pulmonale patients complicated with pulmonary infections can be improved to some extent after the control of infections, and the levels of myocardial enzymes can be reduced to a certain degree.It is necessary to actively take prevention measures and try to control the pulmonary infections as early as possible.

     

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