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目的探讨肺心病合并冠心病的误诊分析。方法收集我院2004年～2008年收治的300例慢性肺心病患者进行回顾性分析。结果因肺心病患者病史较长,长期乏氧,心肌氧张力减低,红细胞增多和肺血管分流,使左、右心室尤其是右心室负荷增加,右心室扩大,一般认为肺心病是右心室受累的心脏病,但肺心病也有左心室损害。缺氧、高碳酸血症、肺部感染对心肌的损害,心输出量的增加以及支气管肺血管分流的形成对左心室负荷的增加以及老年人合并冠心病存在,均可使心脏功能受损加重,应引起临床重视。结论肺心病合并冠心病常见,尤其在基层医院,不具备冠脉造影,但应该提高诊断意识,掌握二病合并的特点,对防止漏诊和误诊、提高临床诊治水平有很大帮助。
Objective To investigate the misdiagnosis of pulmonary heart disease complicated with coronary heart disease. Methods A retrospective analysis of 300 patients with chronic cor pulmonale admitted from 2004 to 2008 in our hospital was performed. Results Pulmonary heart disease patients with a longer history, long-term hypoxia, myocardial oxygen tension decreased, increased red blood cells and pulmonary vascular shunt, so that left and right ventricle, especially the right ventricular load increase, right ventricular enlargement is generally believed that pulmonary heart disease is involved in the right ventricle Heart disease, but pulmonary heart disease also has left ventricular damage. Hypoxia, hypercapnia, pulmonary damage to the myocardium, increased cardiac output and the formation of bronchial and pulmonary vascular shunt on the increase in left ventricular load and the elderly with coronary heart disease exist, can make cardiac dysfunction worse , Should cause clinical attention. Conclusions Coronary heart disease is common in patients with pulmonary heart disease, especially in grassroots hospitals. However, coronary heart disease should not be diagnosed. Coronary heart disease should be improved and the combination of the two diseases should be mastered. This is of great help in preventing misdiagnosis and improving diagnosis and treatment.