摘要
目的 探讨儿童青少年心脏抑制型血管迷走性晕厥(VVS-CI)心电图P波的变化及诊断价值.方法 选择43例明确诊断的VVS-CI儿童青少年为VVS-CI组,同期选取43例健康儿童青少年为对照组.测量两组基础状态下12导联心电图P波时限和电压,并分析其变化特点.结果 VVS-CI组心率低于对照组(P<0.05),VVS-CI组P波时间(Pwd)、P波最大时间(Pmax)、P波离散度(Pd)、校正P波最大时间(Pcmax)、校正P波离散度(Pcd)较对照组延长(P<0.05).Pwd、Pmax、Pd、Pcmax、Pcd对儿童青少年VVS-CI有诊断价值(P<0.05).Pwd最佳截断值为78.49 ms,灵敏度为69.77%,特异度为83.72%;Pmax最佳截断值为93.39 ms,灵敏度为76.74%,特异度为90.70%;Pd最佳截断值为27.42 ms,灵敏度为95.35%,特异度为69.77%;Pcmax最佳截断值为120.90 ms,灵敏度为46.51%,特异度为88.37%;Pcd最佳截断值为36.37 ms,灵敏度为83.72%,特异度为72.09%.结论 儿童青少年VVS-CI的Pwd、Pmax、Pd、Pcmax、Pcd明显延长,提示可能存在心房电活动异常.P波界值对儿童青少年VVS-CI具有诊断价值.
Objective To study the change in P wave on electrocardiogram and its diagnostic value in children and adolescents with cardioinhibitory vasovagal syncope(VVS-CI).Methods A total of 43 children and adolescents who were diagnosed with VVS-CI were enrolled as the VVS-CI group,and 43 healthy children and adolescents were enrolled as the control group.P wave duration and P wave voltage were measured by 12-lead electrocardiography in a basal state,and the changes were analyzed.Results Compared with the control group,the VVS-CI group had a significantly lower heart rate(P<0.05)and significantly longer P wave duration(Pwd),P wave maximum duration(Pmax),and corrected P wave maximum duration(Pcmax),as well as significantly higher P wave dispersion(Pd)and corrected P wave dispersion(Pcd)(P<0.05).Pwd,Pmax,Pd,Pcmax and Pcd had a certain diagnostic value in children and adolescents with VVS-CI(P<0.05):Pwd had a sensitivity of 69.77%and a specificity of 83.72%at the optimal cut-off value of 78.49 ms;Pmax had a sensitivity of 76.74%and a specificity of 90.70%at the optimal cut-off value of 93.39 ms;Pd had a sensitivity of 95.35%and a specificity of 69.77%at the optimal cut-off value of 27.42 ms;Pcmax had a sensitivity of 46.51%and a specificity of 88.37%at the optimal cut-off value of 120.90 ms;Pcd had a sensitivity of 83.72%and a specificity of 72.09%at the optimal cut-off value of 36.37 ms.Conclusions Children and adolescents with VVS-CI have significantly increased Pwd,Pmax,Pd,Pcmax,and Pcd,which may indicate abnormal atrial electrical activity.The cut-off value of P wave has a certain diagnostic value in VVS-CI.
作者
王双双
易秀英
纪青
王玉汶
王成
WANG Shuang-Shuang;YI Xiu-Ying;JI Qing;WANG Yu-Wen;WANG Cheng(Department of Pediatric Cardiovasology,Children's Medical Center,Second Xiangya Hospital,Central South University,Changsha 410011,China)
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2019年第11期1084-1088,共5页
Chinese Journal of Contemporary Pediatrics
