P波高尖与青年肺结核患者右心房负荷的相关性研究  

Study on correlation between high-sharp of P wave and right atrial load in youth with pulmonary tuberculosis

作　　者：陈雪婷 朱宏英 卢峰 CHEN Xue-ting;ZHU Hong-ying;LU Feng(Department of Functional,Wuxi No.5 People's Hospital,Wuxi 214000,Jiangsu,China;Department of Emergency,Wuxi Huishcui District People's Hospital,Wuxi 214000,Jiangsu,China)

机构地区：[1]无锡市第五人民医院功能科,江苏无锡214000 [2]无锡市惠山区人民医院急诊科,江苏无锡214000

出　　处：《生物医学工程与临床》2020年第6期667-671,共5页Biomedical Engineering and Clinical Medicine

基　　金：无锡市科技发展项目(KX15-B-22)。

摘　　要：目的研究P波高尖与青年肺结核患者右心房负荷的相关性。方法选择60例肺结核合并右心房负荷患者(合并右心房负荷组),其中男性29例,女性31例;年龄30~38岁,平均年龄35.96岁。另选取单纯性肺结核患者60例(单纯性肺结核组),其中男性30例,女性30例;年龄31~37岁,平均年龄35.90岁。分别对两组患者开展心电图及心脏超声检测,分析两组患者的P波电压值、心电图改变情况、右心室负荷情况之间的差异,分析合并右心房负荷患者的P波电压值与患者右心房负荷情况相关性。结果合并右心房负荷组P波电压值显著高于单纯肺结核组患者[(0.35±0.05) mV vs(0.25±0.03) mV;t=13.284,P=0.000]。合并右心房负荷组电轴偏移、窦性心动过速发生率、ST-T改变及P波高尖发生率显著高于单纯肺结核组(χ2=6.541、4.681、5.261、15.912,P <0.05);合并右心房负荷组患者的RAVImax、RAVImin、RAVIt显著高于单纯肺结核组患者[RAVImax:(32.33±1.09) m L/m2vs (28.25±1.27) m L/m2;RAVImin:(13.42±1.03) m L/m2vs(11.88±1.22) m L/m2;RAVIt:(20.22±3.22) m L/m2vs (17.33±5.33) m L/m2](t=20.971、8.297、3.992,P <0.05),RAVIpre、RAVIp、RAVIa、Tei指数显著低于单纯肺结核组患者[RAVIpre:(3.01±0.22) mL/m2vs (17.51±5.33) mL/m2;RAVIp:(7.41±1.02) m L/m2vs (10.36±1.13) mL/m2;RAVIa:(38.25±2.63) mL/m2vs (44.51±2.16) m L/m2;Tei指数:0.25±0.13 vs0.39±0.11](t=23.382、16.670、15.823、6.368,P <0.05)。患者的P波电压值与RAVImax、RAVImin、RAVIt呈现正相关(r=0.339、0.441、0.497,P <0.05),与患者的RAVIpre、RAVIp、RAVIa、Tei指数呈现负相关(r=-0.449、-0.552、-0.559、-0.367,P <0.05)。结论 P波与患者的右心房的负荷显著相关,可作为心脏功能发生改变的有效指标。Objective To study the correlation between high-sharp of P wave and right atrial load in youth with pulmonary tuberculosis. Methods Sixty pulmonary tuberculosis patients combined with right atrial load(combined right strial load group)were enrolled, which included 29 males and 31 females, aged 30-38 years old with mean age of 35.96 years old. Sixty sim-ple tuberculosis patients were selected as simple tuberculosis group, which included 30 males and 30 females, aged 31-37 years old with mean age of 35.90 years old. The electrocardiogram(ECG) and echocardiography were performed on 2 groups,and differences between P-wave voltage value, ECG changes and right ventricular load were analyzed. The correlation between P-wave voltage value and right atrial load in patients with right atrial load was analyzed. Results In combined right atrial load group, the P-wave voltage of was significantly higher than that of simple pulmonary tuberculosis group[(0.35 ± 0.05) mV vs(0.25 ± 0.03) mV;t = 13.284, P = 0.000];the incidence of electrical axis deviation, sinus tachycardia, ST-T change and highsharp of P-wave peak were significantly higher than those in simple pulmonary tuberculosis group(X^2= 6.541, 4.681, 5.261,15.912, P < 0.05);The right atrial maximum volume index(RAVImax), right atrial minimum volume index(RAVImin) and total emptying volume index of right atrium(RAVIt) were significantly higher than those of simple tuberculosis group[RAVImax:(32.33 ±1.09) mL/m^2 vs(28.25 ± 1.27) mL/m^2;RAVImin:(13.42 ± 1.03) mL/m^2 vs(11.88 ± 1.22) mL/m^2;RAVIt:(20.22 ± 3.22) mL/m^2 vs(17.33 ± 5.33) mL/m^2](t = 20.971, 8.297, 3.992, P < 0.05);right atrial presystolic volume index(RAVIpre), passive emptying volume index of right atrium, passive emptying volume index of right atrium(RAVIp), active emptying volume index of right atrium(RAVIa) and Tei index were significantly lower than those in simple tuberculosis group[RAVIpre:(3.01 ± 0.22) mL/m^2 vs(17.51 ± 5.33) mL/m^2;RAVIp:(7.41 ± 1.02) mL/m^2 vs(10.36 ± 1.13) mL/m^2;RAVIa:(38.

关 键 词：心脏功能 心脏负荷 心电图 P波 相关性 

分 类 号：R521[医药卫生—内科学]