P波离散度与急性心肌梗塞并发阵发性房颤的临床研究

Clinical Study on Relationship Between P-wave Dispersion Degree and Acute Myocardial Infarction Complicated with Paroxysmal Atrial Fibrillation

目的 :探讨急性心肌梗塞并发阵发性房颤 (PAF)与体表心电图P波最大时限 (Pmax)、P波离散度 (Pd)的关系。方法 :观察 2 9例急性心肌梗塞并发阵发性房颤患者 (观察组 )的Pmax和Pd ,并与 2 7例急性心肌梗塞无阵发性房颤患者 (对照组 )比较。结果 :①Pmax、Pd :观察组显著大于对照组 (Pmax :12 5 0 1±7 6 8ms比 10 8 92± 6 32ms ,P <0 0 1;Pd :4 7 2 1± 9 90ms比 30 0 1± 6 95ms ,P <0 0 1)。②Pmax >110ms和Pd >4 0ms预测PAF的敏感性、特异性、阳性预测准确性分别为 86 4 %、82 1%、91 6 %和 88 8%、85 6 %、92 1% ;当Pmax >110ms且Pd >4 0ms预测PAF的敏感性、特异性、阳性预测准确性分别为78 1%、88 2 %、94 0 %。结论 :Pmax延长和Pd增加可能是预测急性心肌梗塞并发PAF的一项指标。

Objective: To study the relationship between acute myocardial infarction (AMI) Complicated with paroxysmal atrial fibrillation (PAF) and the maximum of p-wave interval (Pmax) and dispersion degree (Pd) of surface electrocardiogram (ECG).Method:We measured the Pmax and Pd of 29 cases of AMI complicated with PAF (observed group) and that of 27 ones of AMI without PAF (control group),then compared them.Results:① The Pmax and Pd in observed group were significantly higher than than in control group (Pmax:125.01±7.68 ms versus 108.92±6.32 ms,P<0.01;Pd:47.21±9.90 ms versus 301.01±6.95 ms, P <0.01).②The rate of sensitivity,specificity and positive prediction for predicting PAF with Pmax over 110 ms was 86.4%,82.1% and 91.6% respectively;that with pd over 40 mas was 88.8%,85.6% and 92.1% respectively;that with pmax over 110 ms and Pd over 40 ms was 78.1%,88.2% and 94.0% respectively.Conclusion:The prolonged Pmax and increased Pd may be a predictor for AMI complicated with PAF.