章陈晨 宋双双 刘凌琳

    [摘要] 目的 探讨老年慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)合并急性心肌梗死(AMI)患者的心脏功能变化与预后评价。 方法 选择2015年10月～2017年8月西南医院老年特诊科收治的老年AECOPD合并AMI患者30例作为观察组，另选择同期单纯AMI无COPD急性加重期的患者30例作为对照组。分别用超声心动图检测两组患者心功能相关指标以及右心结构指标，并进行血气分析，检测心肌损伤标志物，记录并发症的发生率及病死率。 结果 观察组血氧分压水平显著低于对照组(P 0.05)。 结论 AECOPD合并AMI早期即可发生心室重构、心肌肥大，且可进一步导致AMI患者心功能进一步恶化，严重影响近期预后。

    [关键词] 慢性阻塞性肺疾病急性加重期；急性心肌梗死；心功能；预后

    [中图分类号] R563.9 [文献标识码] A [文章编号] 1673-7210(2018)07(b)-0096-04

    [Abstract] Objective To investigate the changes of right ventricular function and prognosis evaluation in elderly patients with acute exacerbation of chronic obstructive pulmonary diseases (COPD) and acute myocardial infarction (AMI). Methods From October 2015 to August 2017， in Department of Geriatric， Southwest Hospital， Army Medical University， 30 elderly patients with acute exacerbation of COPD (AECOPD) and AMI patients were selected as the observation group， 30 cases of AMI elderly patients without AECOPD were selected as the control group， heart function index and right heart structure index of two groups were respectively tested by echocardiography ......