102例房性心律失常患者P波离散度的特点分析

Analysis on the characteristics of P-wave dispersion in 102 patients with atrial arrhythmia

目的探讨体表12导联心电图P波离散度(Pd)和P波最大时限(P_(max))对房性心律失常的预测价值。方法选取2016年10月~2017年1月我院收治的频发房早、短阵房速患者102例设为房性心律失常组,通过12导联心电图同步检查测定P波离散度(Pd)和P波最大时限(P_(max)),并与健康体检者106名(对照组)进行对比。结果房性心律失常组的Pd[(41.5±5.2)ms vs(31.4±5.0)ms]和P_(max)[(111.4±7.2)ms vs(105.2±6.7)ms]均明显大于对照组(P均<0.05);与P_(max)≥100 ms比较,将Pd≥40 ms作为预测房性心律失常的指标时,其敏感度(85.3%vs 71.6%)、特异度(85.9%vs 57.6%)及诊断符合率(85.6%vs 64.4%)均明显升高(P均<0.05);与Pd≥40 ms比较,当采用Pd≥40 ms联合P_(max)≥100 ms作为诊断指标时,其敏感度(91.2%vs 85.3%)明显升高,而特异度(53.8%vs 85.9%)和诊断符合率(72.1%vs 85.6%)显著降低(P均<0.05)。结论P波离散度对临床预测房性心律失常有重要价值,联合P_(max)检测能提高对房性心律失常诊断的敏感度。

Objective To investigate the predictive value of P-wave dispersion(Pd)and P-wave maximal time limit(Pmax)of body surface12-lead ECG in atrial arrhythmia.Methods102patients with frequent premature beats and atrial tachycardia who were admitted to our hospital from October2016to January2017were selected as the atrial arrhythmia group.P-wave dispersion(Pd)and P-wave maximal time limit(Pmax)were measured and determined by12-lead electrocardiogram synchronization test,and the results were compared with106healthy subjects(control group).Results The levels of Pd and Pmax in the atrial arrhythmia group were significantly higher than those in the control group.The prediction of sensitivity,specificity and diagnostic compliance rate of atrial arrhythmia via Pd≥40ms was higher than that of Pmax≥100ms.In the diagnosis by Pd≥40ms combined with Pmax≥100ms,the sensitivity was increased,and the specificity and diagnostic compliance rate were decreased.Conclusion Body surface electrocardiogram Pd is an effective index for predicting atrial arrhythmia.The combination of Pd and Pmax is able to improve the diagnostic sensitivity.