P波离散度预测高血压病患者发生阵发性房颤的价值  

The prognosis Value of P wave dispersion in hepertension patients with paroxysmal atrial fibrillation

作　　者：卢辉和[1] 王毅[1] 盛臻强[1] 张莉[1] 管耘园[1] 

机构地区：[1]南通大学第二附属医院心内科,226001

出　　处：《临床心电学杂志》2006年第1期42-43,45,共3页Journal of Clinical Electrocardiology

摘　　要：目的评价高血压病患者发生阵发性房颤的危险因素。方法:记录44例高血压病伴阵发性房颤(Ⅰ组)和45例高血压病不伴阵发性房颤(Ⅱ组)患者的同步12导联心电图,测量P波最大时限(Pmax)、P波最小时限(Pmin)及P波离散度,左房直径(LAD)和左室射血分数(LVEF)。结果Ⅰ组P波离散度显著高于Ⅱ组(P<0.01);Ⅰ组Pmin和LVEF显著低于Ⅱ组(P<0.01);Pmax和左房直径两组之间没有显著差别(P>0.05)。单变量分析显示Pmin、P波离散度和LVEF对阵发性房颤有显著的预测价值,但多变量分析显示仅P波离散度对阵发性房颤具有独立预测价值。结论P波离散度可以识别高血压病患者发生阵发性房颤的高危人群。Objectlve To determine the risk factors in patients with hypertension development of paroxysmal atrial fibrillation （PAF） by measurements of P wave dispersion. Methods 12 surface eletrocardiograms were recorded in 44 hypertensive patients with history of PAF （group Ⅰ ）and in 45 hypertensive patients without history of PAF （group Ⅱ ）. The maximum P wave duration,the minimum P wave duration,and P wave dispersion were calculated from 12-lead surface eletrocardiograms. Left atrial dimension （LAD）and left ventrieular ejection fraction（LVEF） were measured by echocardiography. Results P wave dispersion was significantly＇ greater in group Ⅰ than group Ⅱ. Prom and LVEF were significantly lower in group Ⅰ than group Ⅱ. Pmax and LAD were not significantly different in group Ⅰ than group Ⅱ. In univariate analysis,Pmin ,LVEF and P wave dispersion were significant predictors of PAF,wheras in a multivarator analysis,only P wave dispersion was an independent predictor of PAF. Conclusion P wave dispersion may be an useful marker to identify patients with hypertension at risk of developing atrial fibrillation.

关 键 词：高血压病患者 阵发性房颤 P波离散度 预测价值 同步12导联心电图 P波最大时限 多变量分析 左室射血分数 左房直径 LVEF 

分 类 号：R544.1[医药卫生—心血管疾病] R541.75[医药卫生—内科学]