摘要
目的探讨心房电-机械检测(Pd、Pmax、LAD)和心脏神经内分泌激素BNP水平与阵发性房颤(PAF)相关性及对PAF的预测价值。方法选择130例阵发房颤患者,及92例无房颤者为对照组,分别测定两组P波离散度(Pd),P波最大时限(Pmax),测量左房最大内径(LAD)及监测血液脑钠肽(BNP)水平,随访1～3年,观察两组患者房颤发作情况。结果有PAF患者Pd(p<0.001),Pmax(p<0.001),LA(p<0.05),BNP(p>0.05)大于无PAF患者;单变量分析显示LAD、Pmax、Pd为阵发性心房颤动的预测因子,多变量分析显示Pd为PAF的独立预测因子;以Pd≥45.0ms为切点值预测阵发性房颤的敏感性为90.6%,特异性为70.0%,阳性预测准确率为71.4%。结论Pd、Pmax、LAD及BNP联合分析,对PAF有重要的预测价值,尤其Pd可作为PAF的一个无创特异的独立预测指标。
Objective To investigate their relationships and their forecast values between Cardiac Electro-mechanical （Pd,Pmax,LAD） detection and neurosecretory hormone brain natriuretic peptide （BNP） for paroxysmal atrial fibrillation（PAF）. Methods 130 patients in one group with PAF, and 92 patients in the control group of non-atrial-fibrillation were surveyed their body electrocardiogram only under the condition of sinus rhythm. Those persons have no significance in concomitance risk factors and diseases. The maximum P-wave duration （Pmax）, the minimum P-wave duration （Pmin）and P-wave dispersion （Pd） were measured by electrophysiological recorder. Left atrial diameter （LAD） was computerd by Doppler echocardiogram, and their BNP levels also was measured. To observe their PAF recurrence in 1-3 years. Results The LAD,Pd ,Pmax,BNP of PAF patients were obviously higher than those in control group with significance. Single factor analyzed showing LAD,Pd and Pmax were all forecast factors of PAF, Multi-factor analysis showed Pd was the only forecast factor of PAF. The higher Pd with a cut-off point of 45.0ms as a predictor of PAF occurrence, which the sensitive is 90.6%, the specificity is 70.0%, the positive predictive value is 71.4%. Conclusions The LAD,Pmax,Pd and BNP combined to evaluate, which could increase the predictive values for the PAF recurrence. Especially Pd might be an effective data for PAF prediction, which is a specificity independent forecast index in non-invasive examination.
出处
《临床心电学杂志》
2009年第3期185-187,共3页
Journal of Clinical Electrocardiology
关键词
阵发性房颤
P波离散度
左房内径
paroxysmal atrium fibrillation
P wave dispersion
left atrium diameter
