P波指数对于食管癌术后患者并发阵发性房颤的预测价值  

Predictive value of p-wave index in patients with paroxysmal atrial fibrillation following esophageal cancer surgery

作　　者：仇鑫 高敏[1] QIU Xin;GAO Min(Electrocardiogram Room,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)心电科

出　　处：《皖南医学院学报》2019年第6期549-552,共4页Journal of Wannan Medical College

基　　金：安徽省自然科学基金项目(1708085MH227)

摘　　要：目的:研究术前食管癌病人的心电指标P波指数及其他诱发房颤的高危因素,探讨P波指数在术后并发房颤的预测价值。方法:收集44例食管癌术后并发房颤患者的术前心电指标及临床资料,并随机抽取同期79例手术后未发生房颤病人,比较心电图P波指数及临床相关资料,从而筛选相关的危险因素。结果:房颤组患者的年龄、住院时间、高血压患病率以及其P波指数中Ⅰ导联P波电压比例均高于对照组,差异均有统计学意义(P<0.05);其他指标两组间差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,P波电压(OR=7.908,95%CI:2.889~21.648)和高龄(OR=1.102,95%CI:1.039~1.169)是食管癌术后并发房颤的危险因素。其预测灵敏度为61.4%,特异度为82.3%,准确率为74.8%。结论:高龄及Ⅰ导联P波低电压的患者食管癌术后较易并发房颤,指标具有很好的临床预测价值。Objective:To investigate the P-wave index and other risks inducing atrial fibrillation in patients before esophagus cancer radical surgery for evaluation of the P-wave in predicting incidence of paroxysmal atrial fibrillation following operation.Methods:Post-operative ECG and clinical data were obtained from 44 cases of atrial fibrillation after esophagectomy.Another 79 cases undergone esophagectomy in the corresponding period without post-operative atrial fibrillation were randomly included as controls.Then the two groups were compared regarding the P-wave index and clinical data for determination of the risk factors inducing fibrillation.Results:Patients with post-operative atrial fibrillation were older,and had significantly longer hospital stay,higher incidence of hypertension and elevated P-wave voltage ratio at I-lead than the controls(all P<0.05),yet other indicators remained insignificant between groups(P>0.05).Multivariate logistic regression analysis showed that P-wave voltage(OR=7.908,95%CI:2.889-21.648)and advanced age(OR=1.102,95%CI:1.039-1.169)were risks for incidence of postoperative atrial fibrillation,and the sensitivity,specificity and accuracy were 61.4%,82.3%and 74.8%respectively.Conclusion:Paroxysmal atrial fibrillation is likely to occur in patients of advanced age with lower P-wave voltage at I-lead that can be predictive value in clinic.

关 键 词：P波指数 P波振幅 食管癌术后 房颤 

分 类 号：R735.1[医药卫生—肿瘤]