急性冠脉综合征患者P波变化与阵发性心房颤动关系的研究

Relationship between changes of P wave and paroxysmal atrial fibrillation in patients with acute coronary syndromes

目的观察急性冠脉综合征(ACS)患者并发阵发性心房颤动(PAF)时P波最大时限(Pmax)、P波最小时限(Pmin)、P波离散度(Pd)、P波变异(Pv)的变化,探讨体表心电图P波变化对ACS并发阵发性心房颤动(PAF)的预测价值。方法测定20例ACS并发阵发性心房颤动患者(房颤组)体表心电图的Pmax、Pmin、Pd、Pv,并与26例ACS无阵发性心房颤动的患者(对照组)进行比较分析。结果房颤组Pmax、Pd、Pv与对照组相比显著增加(P<0.05),经Logistic回归分析显示,Pmax、Pd、Pv均是ACS并发PAF的预测因子,但仅Pd是独立预测因子(P<0.001)。结论Pmax、Pd、Pv均可预测急性冠脉综合征患者并发阵发性心房颤动的发生,而Pd是独立的预测因子。

Objective To evaluate the predictive value of maximum P wave duration（Pmax）, minimum P wave duration （Pmin）, P wave dispersion（Pal） and variance of P wave duration（Pv） for paroxysmal atrial fibrillation（PAF） in patients with acute coronary syndromes （ACS）. Methods Pmax, Pmin, Pd and Pv were measured and analyzed in 20 ACS patients with PAF （atrial fibrillation group） and 26 ACS patients without PAF （control group）. Results Pmax, Pd and Pv were found to be significantly higher in atrial fibrillation group than control group（P〈0.05 ）.In Logistic regression analysis, Pmax, Pd and Pv were predictors of PAF in patients with ACS, but only Pd remained as significant independent predictor （P〈0.001）. Conclusion Pmax , Pd and Pv were able to predict the occurrence of PAF in ACS patients, but only Pd remained as significant independent predictor for PAF in patients with ACS,as a significant independent predictor of ACS patients with PAF.