高血压病P波离散度相关因素与房颤的研究

Relationship Between P Wave Dispersion and Paroxysmal Atrial fibrillation in Patients with Hypertensive

目的 探讨P波离散度 (pd)能否预测高血压病患者伴发的阵发性心房颤动的发生。 方法 观察 41例有阵发性心房颤动病史的高血压病患者 (Ⅰ组 )的最大P波时限 (Pmax)、最小P波时限 (Pmin)、Pd、左房内径 (LAD)和左室射血分数 (LVEF) ,并与无阵发性心房颤动病史的 42例高血压病患者 (Ⅱ组 )比较。结果 Pmax:Ⅰ组非常显著高于Ⅱ组 [(1 2 5± 1 4 )ms比 (1 1 2± 1 2 )ms,P <0 .0 0 1 ] ;Pd:Ⅰ组非常显著高于Ⅱ组 [(51± 1 2 )ms比 (36± 8)ms,P <0 .0 0 1 ]。Pmin、LAD两组差别无统计学意义。单因素回归分析显示 :Pmax、Pd、LVEF均是阵发性心房颤动的预测因子。多因素回归分析显示仅Pd是阵发性心房颤动的独立预测因子。结论 Pmax、LVEF和Pd均可能预测高血压病患者伴发的阵发性心房颤动的发生 。

Objective To explore the relationship between P wave dispersion (pd) and paroxysmal atrial fibrillation (PAF) in patients with essential hypertension. Methods We measured the maximum P wave duration (Pmax),the minimum P wave duration (Pmin), P wave dispersion (pd=Pmax-Pmin) from the 12-leads surface electrocardiogram of 41 essential hypertensive patients with history of PAF (groupⅠ,mean age 62) and 42 essential hypertensive patients without history of PAF (groupⅡ,mean age 68). Left atrial dimension (LAD) and left ventricular ejection fraction (LVEF) were measured by echocardiography. Results Pmax and Pd were significantly higher in groupⅠ than in groupⅡ(Pmas, 125±14 ms vs 112±12 ms, P<0.001). LVEF was significantly lower in groupⅠ than in groupⅡ(62±7% vs 66±6%, P<0.05). In univariate analysis, Pmax, Pd and LVEF were significant predictors of PAF, whereas only Pd remained a significant independent predictor of PAF in the multivariate analysis. Conclusions Pmax Pd and LVEF could be used for the prediction of essential hypertensive patients at risk of developing PAF. Pd remained significant independent predictor of PAF in the multivariate analysis.