P波离散度对高血压病者阵发性心房颤动的预测

Clinincal Study of the Prediction of P Wave dispersion to paroxysmal atrial fibrillation in essential hypertensive patients

目的探讨检测P波离散度(Pd)对高血压病者伴发阵发性心房颤动(PAF)的预测。方法选择高血压病PAF者45例为A组,高血压无PAF者45例为B组。窦性心律下测量体表12导联心电图的最大P波间期(Pmax)、最小P波间期(Pmin),并计算Pd(Pd=Pmax-Pmin);心脏超声心动图测量左房直径(LAD),左室射血分数(LVEF)。结果 A组患者的Pd及Pmax显著高于B组(P<0.01);A组LVEF显著小于B组(P<0.05);A组LAD显著高于B组(P<0.05);单因素回归分析显示:Pmax、Pd、LAD及LAEF均为PAF的预测因子;多因素回归分析显示仅Pd是PAF的独立预测因子。结论窦性心律下高血压病PAF者的Pd大于无心房颤动者;Pd是PAF的独立预测因子。

Objective To explore whether patients with essential hypertension at risk of paroxysmal atrial fibrillation(PAF) can be identified in sinus rhythm by measurements of P wave dispersion. Methods Consecutive forty-five patients with the history of PAF(groupA),and forty-five without PAF(groupB)were involved in this study.Twelve-lead surface electrocardiograms were recorded in all patients in sinus rhythm by measurements of P wave dispersion.The maximum P wave duration,the minimum p wave duration,and p wave dispersion(pd=pmax-pmin)were calculated from 12-lead surface ECGs,Left atrial dimension(LAD) and left ventricular ejection fraction(LVEF) were measured by echocardiography. Results P wave and Pmax dispersion were significantly greater in group A than that of group B(P<0.01).LVEF was significantly lower in group A than that of group B(P<0.05),LAD was greater in groupA than that of group B(P<0.05).In univariate analysis,Pmax 、Pd、LAD and LVEF were significant predictors of PAF,whereas only Pd remained a significant independent predictor of PAF in the multivariate analysis. Conclusion P wave dispersion in sinus rhythm was significantly greater in patents with history of PAF than that of patients with hypertension and Pd remained significant independent predictor of PAF.