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目的探讨肺心病合并急性左心功能不全的临床特点及预后。方法对43例急诊接诊的肺心病并发急性左心功能不全患者的临床资料进行回顾性分析。结果 43例患者中男26例,女17例;年龄61～88岁。所有病例均有咳嗽、咳痰、憋喘等原发病的临床症状,并伴有不同程度的呼吸衰竭、心力衰竭症状,血浆B型利钠肽水平均高于500μg/ml。门诊急查心电图均无典型的心肌梗死表现,在治疗过程中发现急性心肌梗死12例,其中2例转入上级医院行冠状动脉介入手术。43例患者疗效显著28例,有效10例,无效5例(均为死亡病例);合并心肌梗死的12例患者死亡3例,病死率为25.0%;其他31例患者死亡2例,病死率为6.5%;总病死率为11.6%。结论肺心病合并急性左心功能不全属于急危重症,且并发症多,预后差,病死率高。
Objective To investigate the clinical characteristics and prognosis of pulmonary heart disease complicated with acute left heart failure. Methods The clinical data of 43 patients with acute pulmonary heart failure complicated with acute pulmonary heart failure were analyzed retrospectively. Results There were 26 males and 17 females in 43 cases, ranging in age from 61 to 88 years. All cases had clinical symptoms of primary disease such as cough, expectoration and wheezing accompanied by respiratory failure, heart failure symptoms and plasma B-type natriuretic peptide levels above 500 μg / ml. Outpatient emergency ECG no typical myocardial infarction performance, found in the course of treatment of acute myocardial infarction in 12 cases, 2 cases transferred to the higher hospital coronary intervention. In 43 cases, 28 cases were significantly effective, 10 cases were effective and 5 cases were ineffective (all were death cases). In the 12 cases with myocardial infarction, 3 cases died and the case fatality rate was 25.0%. In the other 31 cases, 2 cases died and the case fatality rate was 6.5%; total case fatality rate was 11.6%. Conclusions Pulmonary heart disease complicated with acute left heart insufficiency belongs to acute critically ill patients with more complications, poor prognosis and high mortality.