P波特征与冠状动脉旁路移植术后心房颤动关系的Meta分析  

A Meta-analysis of the relationship between P wave character and atrial fibrillation after coronary artery bypass grafting

作　　者：吴芳琴 吴瑛 肖倩 陶文艳 唐泓源 赵海波[2] 

机构地区：[1]北京凶都医科大学护理学院,100069 [2]首都医科大学朝阳医院心脏外科监护室

出　　处：《中华心律失常学杂志》2010年第6期421-425,共5页Chinese Journal of Cardiac Arrhythmias

基　　金：基金项目：国家自然科学摹金（30871049）

摘　　要：目的 通过Meta分析综合评价冠状动脉旁路移植术前12导联心电图P波时限、信号平均心电图P波时限及P波离散度与冠状动脉旁路移植术后心房颤动（房颤）的关系.方法 通过进行文献质量评价,应用RevMan 4.3软件进行敏感性和异质性分析后计算综合效应.结果 13篇文献符合纳入标准.Meta分析结果显示,冠状动脉旁路移植术后发生房颤患者的术前12导联心电图P波时限和信号平均心电图P波时限均比未发生房颤患者长.加权均数差（WMD）分别为3.69ms,95%CI 1.93～5.44 12.23ms,95%CI 4.82～19.63.术前P波离散度两组之间差异无统计学意义.术后P波离散度的增加是否是术后房颤的独立预测因子未获得综合效应.结论 术前12导联心电图P波时限和信号平均心电图P波时限延长与术后房颤高发有关,P波离散度的增加与术后房颤的关系有待进一步研究.Objective To identify the relationship between preoperative P wave duration of 12-lead electrocardiogram（ECG） and signal-average ECG, P wave dispersion and atrial fibrillation （AF） after coronary artery bypass grafting （CABG） by Meta-analysis. Methods Quality of the studies was assessed. Analysis of sensitivity and heterogeneity were performed and cumulative effects were calculated using either fixed or random effects models by RevMan 4. 3. Results Thirteen studies met all inclusive criteria. Overall, preoperative P wave duration of 12-lead ECG and signal-average ECG were longer in patients with AF after CABG. The weighted mean difference in P wave duration between the patients with, those without AF postoperative （POAF） respectively was 3.69 ms（95% CI 1.93-5.44） and 12. 23 ms （95% CI 4. 82-19. 63 ）. There was no significant difference in preoperative P wave dispersion between patients with and without POAF. An increase in postoperative P wave dispersion was not identified as having a cumulative effect on POAF. Conclusion Prolonged preoperative P wave duration of 12-lead ECG and signal-average ECG were associated with an increased risk of POAF. Further studies are needed to confirm the relationship between increases in P wave dispersion and POAF.

关 键 词：P波时限 P波离散度 冠状动脉旁路移植术 心房颤动 META分析 

分 类 号：R54[医药卫生—心血管疾病] R65[医药卫生—内科学]