不同左心房内径患者心电图P波特征指标与阵发性房颤发生的相关性  

Correlation between P-wave characteristic ECG indexes and occurrence of paroxysmal atrial fibrillation in patients with different left atrial diameters

作　　者：孙羽 王庆义[2] 祝娜 SUN Yu;WANG Qingyi;ZHU Na(Department of Function,Zhengzhou Ninth People’s Hospital,Zhengzhou Henan 450012;Department of Cardio-pulmonary Function,Henan Provincial People’s Hospital,Zhengzhou Henan 450003,China)

机构地区：[1]郑州市第九人民医院功能科,河南郑州450012 [2]河南省人民医院心肺功能科,河南郑州450003

出　　处：《实用心电学杂志》2021年第4期269-273,共5页Journal of Practical Electrocardiology

摘　　要：目的探究不同左心房内径(left atrial diameter,LAD)患者心电图P波特征指标与阵发性房颤(paroxysmal atrial fibrillation,PAF)发生的相关性。方法选取75例PAF患者(房颤组),根据LAD分为房颤A组(LAD≥40 mm,16例)、房颤B组(35 mm≤LAD<40 mm,25例)和房颤C组(LAD<35 mm,34例);另选取同期于本院体检的30例非PAF人群作为对照组。对上述各组均进行心电图检查,比较房颤组和对照组最小P波时限(minimum P-wave duration,Pmin)、最大P波时限(maximum P-wave duration,Pmax)、V1导联P波终末电势(P-wave terminal force in lead V1,PtfV1);比较房颤组组内A、B、C 3个亚组Pmin、Pmax、PtfV1。采用Pearson相关系数分析患者不同LAD心电图P波特征与PAF发生的相关性。采用ROC曲线评价患者心电图P波特征对PAF的诊断价值。结果与对照组比较,房颤组Pmin显著降低,Pmax、PtfV1明显升高(P均<0.05)。房颤组内3个亚组间Pmin随着LAD的增大而逐渐减小,Pmax、PtfV1随着LAD的增大而逐渐增大(P<0.05);不同LAD PAF患者Pmin与LAD呈负相关,Pmax、PtfV1与LAD呈正相关(P<0.05)。Pmin、Pmax、PtfV1联合检测诊断PAF的敏感性、特异性、准确性、阳性预测值、阴性预测值、ROC曲线下面积均显著高于单一指标检测(P<0.05)。结论不同LAD患者心电图P波特征与PAF的发生密切相关。Objective To explore the correlation between P-wave characteristic ECG indexes and the occurrence of paroxysmal atrial fibrillation(PAF)in patients with different left atrial diameters(LADs).Methods A total of 75 PAF patients were selected as the observation group.According to LAD,they were divided into group A(LAD≥40 mm,16 cases),group B(35 mm≤LAD<40 mm,25 cases)and group C(LAD<35 mm,34 cases).Another 30 non-PAF people accepting physical examinations in our hospital during the same period were selected as the control group.ECG examination was performed in the above groups.The minimum P-wave duration(Pmin),the maximum P-wave duration(Pmax)and P-wave terminal force in lead V1(PtfV1)were compared between the observation group and the control group.The indexes of Pmin,Pmax and PtfV1 were compared among the subgroup A,B and C in the observation group.The correlation between P-wave characteristics of ECG in patients with differ-ent LADs and the occurrence of PAF was analyzed with Pearson correlation coefficient.The ROC curve was used to evaluate the diagnostic value of P-wave characteristics of ECG for PAF.Results Compared with the control group,Pmin of the observation group significantly decreases while Pmax and PtfV1 significantly increase(P<0.05).With the increase of LAD,Pmin gradually decreases while Pmax and PtfV1 gradually increase among the three subgroups of the observation group(P<0.05);Pmin of PAF patients with different LADs is negatively related to LAD while Pmax and PtfV1 are positively related to LAD(P<0.05).In the diagnosis of PAF,the sensitivity,specificity,accuracy,positive and negative predictive value,and area under curve of the joint detection of Pmin,Pmax and PtfV1 are all sig-nificantly higher than those detected by any single index of the above(P<0.05).Conclusion The P-wave ECG characteristics of patients with different LADs are closely related to the occurrence of PAF.

关 键 词：左房内径 心电图 最小P波时限 最大P波时限 V1导联P波终末电势 阵发性房颤 

分 类 号：R541.7[医药卫生—心血管疾病]