心电图P波特征与急性心肌梗死患者新发房颤相关  

Electrocardiogram P-wave sign is related to new-onset atrial fibrillation of patients with acute myocardial infarction

作　　者：杨多军 刘静涵 YANG Duojun;LIU Jinghan(Department of Cardio-Brain Function,Wuwei Cancer Hospital of Gansu Province,Wuwei 733000,China)

机构地区：[1]甘肃省武威肿瘤医院心脑功能室,甘肃武威733000

出　　处：《基础医学与临床》2024年第11期1569-1572,共4页Basic and Clinical Medicine

基　　金：甘肃省武威市科技局科技计划基金(WW2101117)。

摘　　要：目的探讨动态心电图P波特征与急性心肌梗死(AMI)患者新发房颤(NOAF)(AMI-NOAF)的关系。方法选取甘肃省武威肿瘤医院收治的240例AMI患者,均进行动态心电图检查,收集患者动态心电图P波特征参数及临床资料,分析P波特征与AMI患者临床参数的关系。根据是否发生NOAF分为NOAF组和未发生(non-NOAF)组,采用多因素Logistic回归模型分析AMI发生NOAF的影响因素。结果KillipⅢ~Ⅳ级最小P波时限(P_(min))水平低于Ⅰ~Ⅱ级,最大P波时限(P_(max))、P波离散度(Pd)水平高于Ⅰ~Ⅱ级(P<0.05);240例AMI患者中47例发生NOAF,发生率为19.58%;NOAF组P_(min)水平低于未发生组,P_(max)、Pd水平高于未发生组(P<0.05);NOAF组入院时心率及Killip Ⅲ~Ⅳ级占比高于未发生组(P<0.05);多因素Logistic回归分析结果显示,Killip Ⅲ~Ⅳ级、P_(max)、Pd高水平是影响AMI发生NOAF的独立危险因素(P<0.05)。结论P_(min)、P_(max)、Pd水平与AMI患者Killip分级有关;AMI-NOAF患者动态心电图P波特征异常,其中高水平P_(max)、Pd是影响AMI发生NOAF发生的独立危险因素。Objective To investigate the relationship between dynamic electrocardiogram P-wave sign and new-onset atrial fibrillation(NOAF)in patients with acute myocardial infarction(AMI)(AMI-NOAF).Methods Totally 240 patients with AMI admitted to Wuwei Cancer Hospital were examined by dynamic electrocardiogram.P-wave sign parameters and clinical data of holter electrocardiogram were collected.The relationship between P-wave sign and clinical parameters of AMI patients was analyzed.The patients were divided into NOAF group and nonoccurrence(non-NOAF)group and multivariate Logistic regression model was used to identify the influencing factors of NOAF occurrence in AMI.Results Killip Ⅲ-Ⅳ grade minimum P wave duration(P_(min))level was shorter than that of Ⅰ-Ⅱ grade.Maximum P wave duration(P_(max))and P wave dispersion(Pd)level were higher than that of Ⅰ-Ⅱ grade(P<0.05).NOAF occurred in 47 of 240 AMI patients(19.58%).The level of P_(min) in NOAF group was lower than that in non-NOAF group,and the level of P_(max) and Pd in NOAF group was higher than that in non-NOAF group(P<0.05).The heart rate and the proportion of Killip grade Ⅲ-Ⅳ in NOAF group were higher than those in non-NOAF group(P<0.05).Multivariate Logistic regression analysis showed that Killip Ⅲ-Ⅳ grade,high level of P_(max) and Pd were independent risk factors for NOAF in AMI(P<0.05).Conclusions The level of P_(min),P_(max) and Pd are correlated with Killip grading in AMI patients.AMI-NOAF patients have abnormal P-wave sign in holter electrocardiogram.The high levels of P_(max) and Pd are independent risk factors of AMI and NOAF.

关 键 词：急性心肌梗死 心房颤动 动态心电图 P波特征 传导阻滞 

分 类 号：R541.75[医药卫生—心血管疾病]