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目的探讨老年慢性肺心病伴发冠心病(肺冠心病)的特点,为临床诊断提供参考条件。方法回顾性对照分析常州市第七医院内科1996年1月至2010年12月间收治的老年肺冠心病99例以及同期单纯肺心病132例的临床资料。结果老年肺冠心病有夜间阵发性呼吸困难、心界向左扩大、A2>P以及心率相对缓慢(P<0.01);心电图有心肌梗死、慢性冠状动脉供血不足、左前分支阻滞等改变(P<0.01);X线胸片和超声心动图能发现左心室和/或全心室肥大(P<0.01);血气分析呈过度通气(P<0.01)以及首位死亡原因差异显著(P<0.05)等表现。结论老年肺心病诊断明确,同时具有上述特点时,应考虑伴发冠心病的诊断。
Objective To explore the characteristics of elderly patients with chronic pulmonary heart disease complicated with coronary heart disease (CHD) and provide the reference conditions for clinical diagnosis. Methods Retrospective analysis of 99 cases of elderly pulmonary heart disease and 132 cases of simple pulmonary heart disease in the seventh hospital of Changzhou from January 1996 to December 2010 were retrospectively analyzed. Results Elderly patients with pulmonary heart disease have paroxysmal nocturnal paroxysmal dyspnea, heart bound to the left to expand, A2> P and heart rate relatively slow (P <0.01); myocardial infarction ECG, chronic coronary insufficiency, left anterior branch block and other changes P <0.01). Left ventricular and / or total ventricular hypertrophy can be found by X-ray and echocardiography (P <0.01), hyperventilation (P <0.01) Other performance. Conclusions The diagnosis of pulmonary heart disease in elderly patients with definite diagnosis, with the above characteristics, should be considered with the diagnosis of coronary heart disease.