P波离散度与高血压并发阵发性心房颤动的相关性研究

Relationship between P wave dispersion and paroxysmal atrial fibrillation in essential hypertensive patients

目的:探讨P波离散度(Pd)和高血压患者并发心房颤动的相关性问题。方法:对伴有阵发性心房颤动病史的高血压患者215例,以12导联体表心电图测量最大P波时限(Pmax)、最小P波时限(Pmin)并计算出Pd值,以超声心动图测量左房内径(LAD)和左室射血分数(LVEF)。所有测量值和计算值均与无阵发性心房颤动病史的高血压患者(242例)的进行比较。结果:研究组较对照组Pmax[(123.7±11.2)ms:(115.8±12.6)ms]和Pd[(49.8±12.7)ms:(37.2±10.1)ms]明显延长,差异有显著性(P<0.01)。两组的Pmin、LAD和LVEF差别无显著性(P>0.05)。单因素Logistic回归分析显示,Pmax和Pd是阵发性心房颤动的预测因子。多元Logistic逐步回归分析表明,仅Pd是阵发性心房颤动的独立预测因子(OR=3.136,P<0.01)。结论:Pmax和Pd均可预测高血压患者伴发的阵发性心房颤动的发生,但Pd是阵发性心房颤动的独立预测因子。

Objective： To explore the relationship between P wave dispersion and paroxysmal atrial fibrillation （PAF） in essential hypertensive （EH） patients. Methods： The maximum P wave duration （Pmax）, minimum P wave duration （Pmin） , and P wave dispersion （Pd= Pmax - Pmin） were measured from 12- leads surface electrocardiogram of 215 EH patients with history of PAF （study group） and 242 EH patients without history of PAF （control group）. Left atrial dimension （LAD） and left ventricular ejection fraction （LVEF） were measured by echocardiography. Results： Pmax and Pd were found to he significantly longer in study group than those of control group （P〈0.01）. Difference of Pmin, LAD and LVEF between two groups was not significant （P〉0.05）. In univariate analysis, Pmax and Pd were significant predictors of PAF, whereas only Pd remained a significant independent predictor of PAF in the multivariate analysis. Conclusion： Pd is significant independent predictor of PAF.