慢性肺原性心脏病室性心律失常变化的临床研究

作者	单位
许其倓	上海市纺织工业局第二医院 (上海200090)
金维岳	上海市纺织工业局第二医院 (上海200090)
周明成	上海市纺织工业局第二医院 (上海200090)
秦兴国	上海市纺织工业局第二医院 (上海200090)

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中文摘要:

对20例慢性肺心病患者进行24小时动态心电图、昼夜动脉血气和血清电解质测定,以研究肺心病室性心律失常的变化规律。结果:室性早搏发生率100%,急性发作期频发室性早搏明显增多,脾肾阳虚型夜间短阵室速发生率增多(P<0.05)。符合中医"阴阳论"观点。缓解期多为偶发室性早搏。经多变量分析认为发作期室性心律失常与动脉血气恶化有关,缓解期与低血钾有关。故认为肺心病肺性早搏防治重点在纠正血气紊乱、改善心功能和维持电解质平衡,尤其重视夜间氧疗

英文摘要:

This paper reported the results of 24 hours continuous ECG,day time and overnight arterial blood gas/pH and serum electrolytes in 20 patients with cor pulmonal,in order to investigate the rule of changes of ventricular arrhythmias（VA）.The results were as follows:（1）Incidence of VA in 24 hours Holter Monitering was 100%.（2）Frequent VPBs were increased significantly in period of acute attack （40%,P<0.05）.（3）Non-sustained VT in the nocturnal（40%）was more than the day time in period of attack（P<0.05）.（4）Relationship between VA and variables in period of attack:PaCO₂（r= 0.90）>arterial blood pH（r=-0.87）>PaO₂（r=-0.63）;in relieved period VA were only related to serum potassium（r=-0.86）.The authors speculated the severity of VA in period of attack was related with worse of arterial blood gas/pH,cardiac dysfunction and compensated enhance of sysmpathetic activity.It Seems that the view accorded with theory of Yin-Yang（阴阳）in TCM.

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