P 波离散度对高血压左心室肥厚患者心房颤动的临床意义

Clinical Value of P Wave Dispersion for Predicting Atrial Fibrillation in Patients with Hypertension and Left Ventricular Hypertrophy

【目的】探讨P波离散度对高血压左心室肥厚患者心房颤动的临床价值。【方法】对本院自2010年4月至2013年3月收治的204例高血压左心室肥厚患者，根据患者的病理特征，将104例伴有心房颤动患者作为观察组，100例无心房颤动患者作为对照组，测量两组患者最大P波时限（Pmax ）、最小P波时限（Pmin）、P波离散度（P波离散度＝Pmax -Pmin），比较两组心电图和彩色脉冲多普勒超声心动检查指标左心室质量指数（LVMI）的差异性。【结果】观察组与对照组的P波离散度分别为（45．3±10．8）m s、（30．7±11．0）m s ，两组相比较差异有显著性（ P ＜0．05），观察组Pmax值明显高于对照组 Pmax值，两组相比较差异有显著性（ P ＜0．05）；观察组LVMI值为（152．4±14．9）g/m2，与对照组（101．1±9．2）g/m2比较，差异有显著性（ P ＜0．05）。【结论】P波离散度、Pmax是高血压左心室肥厚患者心房颤动的预测因子，其可为高血压左心室肥厚患者心房颤动的临床诊断提供关键的价值参考。

[Objective] To explore clinical value of P wave dispersion for predicting atrial fibrillation in patients with hypertension and left ventricular hypertrophy .[Methods] Totally 204 patients with hypertension and left ventricular hy-pertrophy in our hospital from April 2010 to March 2013 were chosen .According to the patient＆#39;s pathological features , 104 patients with atrial fibrillation were regarded as the observation group and 100 patients without atrial fibrillation were regarded as the control group .Maximum P wave duration（Pmax） ,minimum P wave duration（Pmin） and P wave disper-sion（Pd=Pmax -Pmin） in two groups were measured .Electrocardiogram（ECG） and color pulse Doppler ultrasonography indexes such as left ventricular mass index （LVMI） in two groups were compared .[Results] P wave dispersion in obser-vation group and control group were （45 .3 ± 10 .8）ms and （30 .7 ± 11 .0）ms ,and there was significant difference between two groups（ P〈0 .05） .Pmax value in observation group was obviously higher than that in control group ,and there was significant difference between two groups （ P 〈 0 .05） .There was significant difference in LVMI value between two groups[（152 .4 ± 14 .9）g/m2 vs （101 .1 ± 9 .2）g/m2 ]（ P〈0 .05） .[Conclusion]P wave dispersion and Pmax are the pre-dictive factors of atrial fibrillation in patients with hypertension and left ventricular hypertrophy .It provides critical value reference for the diagnosis of atrial fibrillation in patients with hypertension and left ventricular hypertrophy .