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目的对高原肺水肿(HAPE)早期心电图与超声心动图改变及其意义进行探讨。方法应用高原症状评分表对急进高原人员进行评分,筛选出高度疑似HAPE者作为重点观察及随访对象,并对全部重点观察及随访对象行心电图与超声心动图检测分析。结果高度疑似HAPE对象中,非HAPE组及HAPE组在早期即出现心电图及超声心动图改变。两组比较,HAPE组窦性心动过速(>100次/min)、电轴右偏、顺钟向转位、不完全性右束支传导阻滞、ST-T改变、P波高尖及肺动脉高压的发生率,在第1d或第2d均显著高于非HAPE组(P<0.01或P<0.05)。结论 HAPE患者早期心动过速、顺钟向转位、P波高尖及肺动脉高压的出现具有重要诊断价值,尤其是早期显著的肺动脉高压的形成,可作为HAPE早期诊断的重要依据。
Objective To investigate the changes of early electrocardiogram (ECG) and echocardiography in high altitude pulmonary edema (HAPE) and its significance. Methods The plateau symptom score was used to evaluate the acute altitude sickness, and the highly suspected HAPE was screened out as the key observation and follow-up object. All the key observation and follow-up objects were detected by electrocardiogram and echocardiography. Results Highly suspected HAPE subjects, non-HAPE group and HAPE group in the early ECG and echocardiographic changes. In the two groups, sinus tachycardia (> 100 beats / min), right axis deviation, clockwise turn, incomplete right bundle branch block, ST-T changes, P wave peak and pulmonary artery in HAPE group The incidence of hypertension was significantly higher than that of non-HAPE group on day 1 or 2 (P <0.01 or P <0.05). Conclusion Early HAPE patients with early tachycardia, cis-translocation, P wave tip and pulmonary hypertension have important diagnostic value, especially the early formation of pulmonary hypertension can be used as an important basis for the early diagnosis of HAPE.