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本文分析了119例肺心病伴冠心病的临床表现、胸片及心电图等的特点.心绞痛是该组患者的主要临床症状,占33.6%.有助于与单纯肺心病鉴别的敏感体征是A_2≥P_2,X线表现为主动脉迂曲、 延长或钙化,ECG为左室或双室大.特异性较强的指标是心浊音界向左或左下扩大,心尖区Ⅱ级SM,A_2 ≥P_2.ECG对鉴别肺心病伴冠心病及单纯肺心病有较重要的价值.较敏感的指标是Rv_1+Sv_5>1.05,V_2S/R≤3,DBI≤1,特异性较高的指标是LAH、CRBBB、房颤及心梗.鉴别慢支伴冠心病与肺心病伴冠心病较特异的指标是Rv_1+Sv_5/Rv_5+Sv_1>0.7V_1呈Qr,CRBBB,房颤,电轴右偏.文中对肺心病伴冠心病的诊断标准又提出了新的修正意见.
This article analyzes the clinical manifestations of 119 cases of pulmonary heart disease with coronary heart disease, chest X-ray and ECG characteristics.The angina pectoris is the main clinical symptoms of this group of patients, accounting for 33.6% .And help to identify with simple pulmonary heart disease is A_2 P_2, X-ray showed tortuous, prolonged or calcified aorta, ECG for the left ventricle or two-compartment large specific indicators of the heart is voiced orbital left or left to expand the apex of the SM Ⅱ, A_2 ≥ P_2.ECG Coronary heart disease and simple pulmonary heart disease in the identification of more important value, the more sensitive indicators are Rv_1 + Sv_5> 1.05, V_2S / R≤3, DBI≤1, high specificity indicators are LAH, CRBBB, Fibrillation and myocardial infarction.Differentiated chronic coronary heart disease and pulmonary heart disease with coronary heart disease more specific indicators of Rv_1 + Sv_5 / Rv_5 + Sv_1> 0.7V_1 were Qr, CRBBB, atrial fibrillation, right axis deviation.In this paper, pulmonary heart disease with Coronary heart disease diagnostic criteria and put forward new amendments.