摘要
目的该研究旨在观测阵发性心房颤动患者的P波离散度、P波最大时限及心功能的变化;研究Pd及Pmax对阵发性心房颤动(PAF)的预测价值,Pd与心功能的关系。方法PAF的患者34例(PAF组)包括Ⅰ组(特发性心房颤动18例)和Ⅱ组(伴有高血压和/或冠心病者16例)、健康对照组36例,测量两组的Pd和Pmax,并以ⅢPmax≥110ms和Pd≥40ms为标准,评估Pd、Pmax和Pd+Pmax对PAF的预测价值。测定LVEF、EV/AV及IVRT,分析Pd与心功能的关系。结果:PAF组Pd和Pmax增大(117.53±9.08ms,44.26±7.06ms)与对照组(99.25±10.24ms,26.78±6.42ms)相比差异有显著性(P<0.01)。Pmax≥110ms、Pd≥40ms及Pd≥40ms+Pmax≥110ms时,预测心房颤动的敏感性分别为85.3%、82.4%、79.4%;特异性分别为83.3%、88.9%、91.7%;阳性预测准确度分别为82.9%、87.5%、90.0%。PAF组LVEF降低和EV/AV缩小(0.426±0.134,EV/AV<1的阳性率为77.4%)与对照组(0.619±0.113,19.4%)相比较差异均有显著性(p<0.05)。结论PAF患者Pd明显增大。Pd是有效预测PAF的体表心电图指标之一。PAF患者Pd增大与心功能不全有一定关系。
Objective The aim of this study was to observe the change of the P wave dispersion(Pd),the maximum P wave duration(Pmax) and cardiac function in the patients with paroxysmal atrial fibrillation(PAF).To study the predictive value of Pd for PAF,the relationship between Pd and cardiac function. Methods Pd and Pax were measured in 34 patients with PAF and 36 healthy controls.The PAF patients were divided into 2 groups;group A included 18 patients with idiopathic paroxysmal atrial fibrillation and group B included 16 patients with PAF companied essential hypertension and/or coronary heart disease.The predictive value of Pd,Pmax or both were evaluated using Pmax≥110ms and Pd≥40ms as the criteria.Determined the interrelated parameters of cardiac function in PAF group and 36 healthy controls;left ventricular ejection fraction(LVEF),flowing velocity ratio of E wave and A wave (EV/AV) and isovolumic relaxation time(IVRT),anal were measured and relationship between Pd and cardiac function was andlyzed. Results Pmax and Pd were higher significantly in PAF group (117.53±9.08ms,44.26±7.06ms) than those in normal subjects(99.25±10.24ms,26.78±6.42)(p<0.01).Pmax of 110ms and Pd of 40ms and Pmax+Pd separated patients from controls with a sensitivity of 85.4% and 79.4%;a specificity of 83.3% 88.9% and 91.7%;and a positive prediction accuracy of 82.9%,87.5% and 90%.Both of the cardiac function parameters-LVEF and EV/AV decreased obviously (0.426±0.134,a 77.4% positive ratio of EV/AV<1) respectively compared with controls(0.619±0.113,19.4%)(P<0.05). Conclusions There were a significant change of Pd in patients with PAF.Pd is one of the effective electrocardiographic markers used to predict PAF.There was certain relationship betwween increased Pd and cardiac dysfunction.
出处
《临床心电学杂志》
2004年第2期108-111,共4页
Journal of Clinical Electrocardiology
