V_1导联P波终末电势与心力衰竭心功能及心律失常的关系研究

The clinical value of P wave terminal force in Lead V_1 in evaluation of cardiac function and arrhythmia in patients with heart failure

目的探讨心电图V1导联P波终末电势(Ptfv1)与心力衰竭(HF)患者心功能分级及并发心律失常的关系。方法选择2010年2月至2013年12月在新疆医科大学第五附属医院心内科住院并确诊为HF的434例患者为HF组;同期274例健康体检者为对照组。入组者行常规心电图检查,测量计算Ptfv1值;行24 h动态心电图检查,进行心律失常监测分析,各组按不同Ptfv1区间值分为各亚组,分析计算各亚组的心律失常患病率。分析比较Ptfv1值与心功能分级、心律失常患病率的关系。结果 HF组各心功能分级间、对照组Ptfv1值中位数、四分位数间距依次为0(8-0)、8(22-0)、16(36-8)、20(36-12)、0(0-0)mm·ms,各组间Ptfv1值差异有统计学意义(P<0.05),Ptfv1值与心功能分级呈正相关(r=0.236,P<0.01)。相同心功能分级不同Ptfv1值区间,心律失常患病率差异有统计学意义(P<0.05)。结论Ptfv1值与心功能分级相关,Ptfv1值随心功能分级的增加而增大。相同心功能分级HF患者心律失常患病率随Ptfv1值的增大而增高。

Objective To explore the relations of P wave terminal force in Lead V1（Ptfv1） with cardiac functional grading and the prevalence of arrhythmias in patients with heart failure（HF）. Methods A total of 434 patients confirmed with HF were included as HF group, and 274 healthy individuals served as control group.The ECG was recorded and Ptfv1 was calculated; arrhythmia was monitored and each group was divided into subgroups based on Ptfv1 value. The arrhythmia rate in each subgroup was also calculated. The relations of Ptfv1 value with cardiac functional grading and the prevalence of arrhythmias were analyzed. ResultsPtfv1 values of cardiac function of HF group and control group were 0（8-0）, 8（22-0）, 16（36-8）, 20（36-12） and 0（0-0） mm·ms.There were significant differences on Ptfv1 values in each group（P〈0.05）; Ptfv1 value was positively correlated with cardiac functional grading（r=0.236, P〈0.01）.And during different Ptfv1 interval at the same cardiac function grading, there were significant differences on the prevalence of arrhythmias（P〈0.05）. Conclusion Ptfv1 value is positively correlated with cardiac functional grading, at the same cardiac function grading, the higher the Ptfv1 value,the higher the prevalence of arrhythmias.