P波离散度预测扩张型心肌病伴阵发性心房颤动的临床价值  

The clinical value of predicting dilated cardiomypathy with paroxysmal atrial fibrillation by P wave dispersion.

作　　者：马晶茹[1] 高勇[1] 李璐[1] 徐旺达[1] 金霞[1] 

机构地区：[1]沈阳医学院第二附属医院,110002

出　　处：《临床心电学杂志》2004年第4期256-258,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨P波离散度(Pd)预测扩张型心肌病(DCM)伴阵发性心房颤动(PAF)的价值。方法30例DCM伴阵发性Af者(A组),26例DCM无Af者(B组)。通过12导联体表心电图测定P波最大持续时间(Pmax)与最小持续时间(Pmin),计算Pd(Pd=Pmax-Pmin)。比较A组与B组的Pd与Pmax。结果A组Pd为48.44-13.8ms,Pmax为122.84-13.7ms,Pmin为76.2±12.0ms,与B组Pd30.6±10.2ms,Pmaxll0.2±10.4ms,Pmin80.8+11.5ms相比明显延长(p<0.01)。A组左房(LA)内径41.415.6mm,B组LA内径40.24-6.2mm,两组相比无显著差异(p>0.05)。为预测Af,取P波时限≥120ms,Pd≥40ms以及两者相结合,敏感性分别为86%、90%、73%,特异性分别为80%、85%、89%,阳性预测值分别为84%、87%、88%。结论Pd增加和P波宽度延长,可预测DCM并发阵发性Af的危险性。Objective To discuss the value of predicting dilated cardiomypathy(DCM) with paroxysmal atrial fibrillation(PAF) by P wave dispersion(Pd). Methods 30 patients with DCM with a history of PAF(Group A) and 26 patients with DCM without a history of PAF(Group B)are studied. Maximum(Pmax) and minimum(Pmin) P wave durations, as well as P wave dispersion(Pd=Pmax-Pmin) are calculated from 12-lead surface electrocardiograms(ECG). Comparing the change of Pd and Pmax of the two groups. Results Pd is significantly different between the groups(Group A: 48.44' 13.8ms vs. Group B: 30.6± 10.2ms ( p<0.01), and Pmax(Group A: 122.8±13.8ms vs. Group B: 110.2±10.4ms ) and Pmin( Group A:76.2± 12.6ms vs. Group B:80.8±4-ll.5ms) also have clear difference (p<0.01). While the left atrial diameter of two groups is not significantly different( Group A:41.44-5.6mm vs. Group B:40.24- 6.2mm: p>0.05).When Pmax ≥ 120ms, Pd ≥ 40ms and combining the two targets, a sensitivity of 86%, 90%, 73% and a specificity of 80%, 85%, 89% and postive predicting value of 84%,87%,88% Can be got in order to predict PAF. Conclusions This study suggets that the increasing of Pd and P wave durations can identify patients with DCM who are likely to develop PAF.

关 键 词：DCM 阵发性心房颤动 P波离散度 扩张型心肌病 临床价值 体表心电图 PAF 阳性 预测 导联 

分 类 号：R542.2[医药卫生—心血管疾病]