心电图PtfV_1与胸部放疗期间左室舒张功能的相关性及其临床意义

Correlation between PtfV_1 and left ventricular diastolic function during chest radiotherapy and its clinical significance

目的探讨心电图V1导联P波终末电势(Ptf V1)与胸部放疗期间左室舒张功能的相关性及其临床意义。方法检测并比较80例胸部肿瘤患者放疗前、后的心电图Ptf V1和超声心动图指标:左室舒张早期流速峰值(E)与晚期流速峰值(A)比值(E/A)、E峰减速时间(EDT)、左房内径指数(LADI)、左室射血分数(LVEF);分析心电图Ptf V1与超声检查的左室舒张功能指标的相关性;胸部放疗后将所有患者以Ptf V1≤-0.03 mm·s为界值分组,统计并分析两组左室舒张功能障碍的构成比。结果 (1)胸部放疗后患者Ptf V1和E/A显著降低,EDT、LADI显著增加(均P<0.01),LVEF无显著差异;(2)Pearson相关分析示Ptf V1与EDT(r=-0.218,P<0.01)、LADI(r=-0.185,P<0.05)呈显著负相关;(3)多因素Logistic回归分析示Ptf V1、EDT、E/A是左室舒张功能障碍的影响因素;(4)胸部放疗后左室舒张功能障碍构成比比较示:-0.03<Ptf V1≤-0.02 mm·s组早期舒张功能不全占78%,Ptf V1≤-0.03mm·s组中期左室舒张功能障碍占73%,两组早、中期左室舒张功能障碍构成比存在显著差异(P<0.01)。结论心电图Ptf V1与超声心动图左室舒张功能参数存在显著相关性,示胸部放疗期间左室舒张功能障碍的影响因素,可作为评价胸部放疗患者左室舒张功能障碍的客观指标。

AIM To investigate the correlation between P wave terminal force in electrocardiogram lead V1 （PtfV1） and left ventricular diastolic function during Before and after chest radiotherapy, 80 patients chest radiotherapy and its clinical value. METHODS who received chest radiotherapy had measurements taken of PtfV1 by ECG and left ventricular diastolic early peak velocity （E）, late peak velocity （A） ratio （E/A）, E wave decelerating time （EDT）, left atrial dimension index （LADI）, and left ventricular ejection force （LVEF） by echocardiogram. The correlation of PtfV1 and left ventricular diastolic function detected by echocardiogram was also analyzed and after chest radiotherapy, those patients were divided into two group： PtfV1 ≤ -0. 03 mm.s guroup and -0. 03 〈 PtfV1 ≤ -0. 02 mmos group, and constituent ratio of left ventricular diastolic dysfunction were analyzed in each group. RESULTS ①After chest radiotherapy, PtfV1 and E/A decreased significantly, EDT and LADI increased significantly （P 〈 0. 01 ）, and LVEF had no significant difference. ②Pearson correlation analysis showed that the PtfV1 was negative correlation with EDT（ r = - 0. 218, P 〈 0. 01 ）, LADI （ r = - 0. 185, P 〈 0. 05 ）. ③Multivariate Logistic regression analysis showed that PtfV1 , EDT, E/A were the influence factors of left ventricular diastolic dysfunction. ④Left ventricular diastolic dysfunction constituent ratio comparison showed： early diastolic dysfunction rate of - 0. 03 〈 PtfV1 ≤ - 0.02 mmos group was 78% , middle left ventricular diastolic dysfunction rate of PtfV1 ≤ -0. 03 minos group was 73% ; early and mid left ventricular diastolic dysfunction incidence between two groups were significant difference （P 〈 0. 01 ）. CONCLUSION PtfV1 has significant correlations with the parameters of left ventricular diastolic function by echacardiogram, and is an influencing factor of left ventricular diastolic dysfunction during chest radiotherapy. Thus, it can be as the objective index for evaluating the chest radiotherapy patients in left ventricular diastolic dysfunction.