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目的探讨心电图和心脏生物标志物对识别急性肺动脉栓塞(APE)患者右心室功能不全的价值。方法选择36例经肺动脉加强CT确诊的APE患者,应用超声心动图检测患者右心功能,并分别行心电图和肌钙蛋白(cTnI)及B型利钠肽(BNP)的检测。结果心电图V1～V3T波倒置对APE患者右心功能不全的敏感性为75.0%,这些结果均优于cTnI及BNP对于右心功能不全的早期诊断。V1～V3T波倒置可持续整个右心功能不全期。结论心电图V1～V3T波倒置对于右心功能不全的早期诊断有很高的敏感性和准确性,V1～V3T波的正常化和右心功能的恢复有关。
Objective To investigate the value of ECG and cardiac biomarkers in identifying right ventricular dysfunction in patients with acute pulmonary embolism (APE). Methods Thirty - six patients with APE diagnosed by pulmonary artery enhanced CT were enrolled in the study. The right heart function was measured by echocardiography. The levels of cTnI and BNP were measured respectively. Results The sensitivity of electrocardiogram V1 ~ V3T wave inversion to right ventricular dysfunction in patients with APE was 75.0%. These results were superior to those of cTnI and BNP in the early diagnosis of right ventricular dysfunction. V1 ~ V3T wave inversion can sustain the entire right ventricular dysfunction period. Conclusion ECG V1 ~ V3T wave inversion has a high sensitivity and accuracy for the early diagnosis of right ventricular dysfunction. The normalization of V1 ~ V3T wave is related to the recovery of right heart function.