P波电轴、时限及离散度对阵发性心房颤动的预测价值  

The value of P-wave axis,time limit and dispersion in predicting paroxysmal atrial fibrillation

作　　者：孟润轲 李世锋[1] MENG Runke;LI Shifeng(Department of Electrocardiography,the Second Affiliated Hospital of Zhengzhou University,Henan,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院心电图科,河南郑州450000

出　　处：《中国医药科学》2022年第9期15-18,共4页China Medicine And Pharmacy

基　　金：河南省医学教育研究项目(Wjlx2021308)。

摘　　要：目的探讨P波电轴(PWA)、时限及离散度对阵发性心房颤动的预测意义。方法回顾性分析2019年6月至2021年6月在郑州大学第二附属医院住院的患者共112例,将其中54例在住院期间发生阵发性心房颤动的患者作为房颤组,58例同时期住院期间未发生心房颤动的患者作为对照组,所有患者均接受常规心电图及动态心电图检查,分别测量两组患者的PWA、P波最大时限(Pmax)、P波离散度(Pd),以异常P波电轴(aPWA)<0°或>75°、Pmax≥110 ms、Pd≥40 ms为异常标准进行组间比较分析,比较两组患者的一般资料及心电图指标。结果房颤组aPWA比例、Pmax、Pd与对照组比较均增大,差异有统计学意义(P<0.05)。以aPWA<0°或>75°、Pmax≥110 ms、Pd≥40 ms为标准,单独或联合使用对阵发性房颤的预测结果比较,在所有指标中以PWA+Pmax+Pd的特异度和阳性预测值最高。结论PWA异常、Pmax延长及Pd延长对于阵发性心房颤动的发生有一定的预测价值。Objective To investigate the value of P-wave axis(PWA),time limit and dispersion(Pd)in predicting paroxysmal atrial fibrillation(PAF).Methods A total of 112 patients hospitalized in the Second Affiliated Hospital of Zhengzhou University from June 2019 to June 2021 were retrospectively analyzed,and 54 of them who developed PAF during hospitalization were selected as the atrial fibrillation group,and the remaining 58 patients who had no atrial arrhythmia episodes during the same period were selected as the control group.All patients underwent conventional electrocardiography and dynamic electrocardiography to measure the PWA,maximum time limit of P wave(Pmax)and P-wave dispersion(Pd).The inter-group comparison was conducted with abnormal P-wave axis(aPWA)<0°or>75°,Pmax≥110 ms,and Pd≥40 ms as the abnormal criteria,and the general data and electrocardiograph indexes were compared between the two groups.Results The proportion of aPWA,the Pmax and Pd were all increased in the atrial fibrillation group compared with the control group,with statistically significant differences(P<0.05).The predictive results of PAF by aPWA<0°or>75°,Pmax≥110 ms,and Pd≥40 ms,alone or in combination:the specificity and positive predictive value were the highest by PWA+Pmax+Pd among all indexes.Conclusion Abnormal PWA,prolonged Pmax and lengthened Pd have certain pre dictive values for the occurrence of PAF.

关 键 词：阵发性心房颤动 P波电轴 P波最大时限 P波离散度 

分 类 号：R541.75[医药卫生—心血管疾病]