心电图V_1导联P波终末电势与心功能不全的相关性研究

The relativity between P wave terminal force in lead V_1 and cardiac insufficiency

目的探讨导联P波终末电势（PwaveterminalforceinleadJtfVi)对心功能不全患者的临床价值及其与左室射血分数（leftventricularejectionfraction，LVEF)的相关性。方法选择我院心内科收治的87例心功能不全患者及85例正常体检者分别作为试验组和对照组。测量、计算入选者的体表心电图卩11'￥1值和超声心动图LVEF值，比较这两项指标在两组间的差异。同时，比较试验组PtfVi值在LVEF轻度下降（LVEF4〇%?50%)、中度下降（LVEF30%?40%)及重度下降（LVEF<30%)时的变化及其与对照组Ptf^值之间的差异。结果①试验组的LVEF值显著低于对照组[(37.32±8.36)%i(60.79±6.56)%，P<0.05]JtfVi值亦然[(-0?067±-0?021)mm?s版（-0?017±-0?009)mm?Sj/^O.OS]。②在LVEF轻度、中度和重度下降的试验组患者中，PtfVi值依次降低[(-0.047±-0.007)mm.s—（-0.071士-0.010)mm.s—（-0.095±-0.013)mm.s]，且均低于对照组，差异均有统计学意义（P<0.05)，说明Ptf^值随LVEF的下降而下降。结论心功能不全患者的Ptf^值随着LVEF值的下降明显下降，且与心功能不全的严重程度呈正相关。因此，只^1可作为心功能不全严重程度的一项实用的评估指标。

Objective To investigate the clinical value of P wave terminal force in lead (PtfY1) among patients with cardiac insufficiency and the relationship between PtfV1 and left ventricular ejection fraction (LVEF). Methods A total of 87 patients with cardiac insufficiency were selected as experimental group who had been admitted by the department of cardiology in our hospital. Another 85 cases of healthy people were enrolled as control group. We measured and calculated their PtfY1 in body surface ECG and LVEF in echocardiogram. The differences of the two indices were compared between experimental and control groups. At the same time, we compared the changes of PtfV1 in experimental group with mild, moderate and severe decline of LYEF[ (40 ~50)% ,(30 ~ 40)% , and ( <30% ) ] respectively as well as the index separately between the three subgroups in experimental group and control group.Results (i) The LVEF value of experimental group was significantly lower than that of control group [(37.32 ± 8. 36) % 队(60. 79 ± 6.56) % , < 0? 05 ] , and so was PtfVi value [ ( - 0? 067 士-0.021) mm ? s vs. ( - 0? 017 ± -0? 009) mm ? s, P <0? 05 ] ? ( ii) Among the patients separately with mild, moderate and severe decline of LVEF, PtfVi value orderly decreased [ ( - 0? 047 士-0.007) mm ? s,( -0.071 ± -0.010) mm ? s, and ( -0.095 ± -0.013) mm ? s]. The PtfV^value in each of the three subgroups was lower than that in control group, with statistically significant difference( P < 0. 05 ) . It indicated that PtfY1 reduced with the decrease of LVEF. Conclusion In the patients with cardiac insufficiency, PtfY1 declines significantly with the decrease of LVEF and the index is positively correlated with the severity of cardiac insufficiency. Therefore, PtfY1 can be applied in evaluating the severity of cardiac insufficiency as a practical index.