P波指数在阵发性心房颤动后脑梗死预测中的应用

Application of P-wave Index in the Prediction of Cerebral Infarction after Paroxysmal Atrial Fibrillation

目的探究P波指数对阵发性心房颤动后脑梗死的预测价值。方法选取2021年1月—2023年12月盐城市第三人民医院收治的106例确诊为脑梗死患者为研究对象,其中53例单纯脑梗死患者纳入对照组,53例阵发性心房颤动后脑梗死患者纳入观察组。所有患者均接受12导联心电图检查,记录P波指数,并绘制受试者操作特征(receiver operating characteristic,ROC)曲线,分析P波指数预测阵发性心房颤动后脑梗死发生的价值。结果观察组P波时限、V1导联P波终末电势及P波离散度均高于对照组,差异有统计学意义(P均<0.05)。两组PR间期比较,差异无统计学意义(P>0.05)。ROC曲线显示,P波时限、V1导联P波终末电势及P波离散度预测心房颤动后脑梗死发生的ROC曲线下面积分别为0.834、0.938、0.987,且预测阵发性心房颤动后脑梗死发生的灵敏度和特异度均较高,均具有良好的预测价值(P均<0.05)。结论P波时限延长、V1导联P波终末电势及P波离散度升高是预测阵发性心房颤动后脑梗死发生的重要指标,可为确诊患者病情提供参考。

Objective To explore the predictive value of P-wave index in cerebral infarction after paroxysmal atrial fibrillation.Methods A total of 106 patients diagnosed with cerebral infarction admitted to Yancheng Third People's Hospital from January 2021 to December 2023 were selected as the study subjects,including 53 patients with simple cerebral infarction as the control group and 53 patients with cerebral infarction after paroxysmal atrial fibrillation as the observation group.12-lead electrocardiogram examination was performed and P-wave index was recorded.The receiver operating characteristic(ROC)curve was plotted to analyze its value in predicting cerebral infarction after paroxysmal atrial fibrillation.Results The P-wave duration,V1 lead P-wave terminal potential and P-wave dispersion in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).There was no significant difference in PR interval between the two groups(P>0.05).ROC curve showed that the area under ROC curve of Pwave duration,V1 lead P-wave terminal potential and P-wave dispersion in predicting the occurrence of cerebral infarction after paroxysmal atrial fibrillation were 0.834,0.938 and 0.987,respectively,and the sensitivity and specificity of predicting the occurrence of cerebral infarction after paroxysmal atrial fibrillation were high,which had good predictive value(all P<0.05).Conclusion Prolonged P-wave duration,increased V1 lead Pwave terminal potential and P-wave dispersion are important indicators to predict the occurrence of cerebral in farction after paroxysmal atrial fibrillation,which can provide a reference for the diagnosis of patients with disease assessment.