24h动态心电图中房性快速心律失常与P波离散度(Pd)的关系研究  

Study on the relationship between atrial arrhythmias and P wave dispersion(Pd) in 24h dynamic electrocardiogram

作　　者：潘华 杜建英 张文静 李国平 

机构地区：[1]东营市人民医院特检科

出　　处：《中国心血管病研究》2018年第1期46-48,共3页Chinese Journal of Cardiovascular Research

摘　　要：摘要目的：通过观察24h动态心电图，分析患者在发生房性快速心律失常时，Pd的变化情况，并分析之间的关系。方法：取我院2014年4月至2016年10月就诊的126例房性快速心律失常患者，分为A组（偶发房早）、B组（频发房早及短阵房速）、C组（阵发性房颤）、D组为正常的健康体检者，检测并记录患者的Pd、Pmax、LADD及Pd、Pmax阳性率，并预测Pd、Pmax对房性快速心律失常的阳性预测值、阴性预测值、灵敏度、特异度。结果：通过检测，结果显示，房性快速心律失常患者的Pd、Pmax都升高显著，其中C组最为显著，较正常对照组，差异显著（P＜0.05），和LADD关系不大；A、B、C三组中，B组的Pd、Pmax阳性率分别为66.67%、71.43%，C组的Pd、Pmax阳性率分别为78.57%、83.33%，较A组（40.48%、47.62%）显著升高，差异明显（P＜0.05）；比较Pd和Pmax的预测值，灵敏度比较接近，阳性预测值和特异度较Pmax升高明显，阴性预测值则微微低于Pmax；比较Pmax＋Pd发和单个的指标，阴性预测值与特异度下降（60.34%、61.80%），但是阳性预测值与灵敏度有所增加（92.07%、93.20%）。结论：Pd （P波离散度）可以作为预测房性心律失常的一个新的指标，而联合检测Pd与Pmax可以进一步提高诊断的敏感度。Objective To observe the 24 h dynamic electrocardiogram analysis, occurred in patients with atrial tachyarrhythmias, changes of Pd, and analyze the relationship between the. Methods 126 patients with atri- al tachyarrhythmia patients in our hospital from April 2014 to October 2016 were divided into A group（occasional atrial premature）, B group （frequent premature atrial and atrial tachycardia） and C group （PAF）, group D was normal healthy subjects. The Pd, Pmax, LAI）D and Pd, the positive rate of Pmax were recorded, and positive predictive value, negative predictive value, sensitivity and specificity of Pd and Pmax for atrial tachyarrhythmias were analyzed. Results The results showed that the Pd, Pmax increased significantly in atrial tachyarrhythmias patients, especially in C group, when compared with normal control group the differences was significance（P〈0.05）, and LADD A, B, C; group three, B group Pd, Pmax positive rates were 66.67%, 71.43%, C group Pd, Pmax positive rates were 78.57%, 83.33%, compared with the A group （40.48%,47.62%）, significantly increased significantly （P〈0.05）; forecast comparison between Pd and Pmax, the sensitivity is relatively close, positive predictive value and specificity of Pmax was increased significantly, the negative predictive value is slightly lower than that of Pmax; Pmax＋Pd and single index, negative predictive value and specificity （60.34%, down 61.80% ）, but increased the sensitivity and positive predictive value （92.07%, 93.20%）. Coneltmion Pd （P dispersion） can be used as a new predictor of atrial arrhythmia, and the combined detection of Pd and P Max can further improve the sensitivity of the diagnosis

关 键 词：房性快速心律失常 24小时动态心电图 P波离散度 

分 类 号：R541.7[医药卫生—心血管疾病]