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为了对老年高原慢性心脏病(简称高原心)与高原慢性肺心病(简称肺心病)进行鉴别诊断,在海拔3200～3800米地区,10年来共调查10,300例,从中挑选出高原心与肺心病各20例进行对比分析。从病史、症状、体征、预后以及两病同时并存的鉴别提出了诊断依据。从X线胸片征象和心血管径线测量指标,两病具有明显的鉴别,并提出了右心室增大对两病早期的诊断价值。心电图提示,除两病有异同点外,对晚期高原心提出了左心室肥厚的观点。肺功能检查,两肺均有不同程度的损害,4项肺功常数经t测验,除一秒率无显著差异外,均有非常显著的差异(P<0.01)。化验检查,全血比粘度和红细胞压积,肺心病组高于高原心组。据此提出了目前还没有见到的以紧紧结合临床为主的综合鉴别诊断。
In order to differentiate elderly patients with chronic heart disease on the plateau and plateau patients with chronic pulmonary heart disease (CKD), 10,300 cases were surveyed in the areas between 3200 and 3800 meters above sea level in 10 years. 20 cases for comparative analysis. From the history, symptoms, signs, prognosis and the simultaneous identification of two diseases put forward the diagnosis basis. From the X-ray signs and cardiovascular diameter measurement indicators, the two diseases were clearly identified, and made the right ventricular enlargement of the early diagnosis of both diseases. ECG prompts, in addition to similarities and differences between the two diseases, the heart of the late high altitude left ventricular hypertrophy point of view. Lung function tests, both lungs have varying degrees of damage, four pulmonary function tests by t test, except one second rate was no significant difference, there is a very significant difference (P <0.01). Laboratory tests, whole blood specific viscosity and hematocrit, pulmonary heart disease group was higher than the heart group. Accordingly, we have not yet seen a comprehensive clinical diagnosis of closely integrated with the differential diagnosis.