P波离散度对高血压患者并发心房颤动预测价值.doc

P波离散度对高血压患者并发心房颤动预测价值[摘要] 目的：探讨P波离散度在高血压患者阵发性心房颤动发生中的预测价值。方法：将95例高血压患者按有无房颤分为两组，采用同步12导联体表心电图测量Pmax、Pmin和Pd，超声心动图测定左心房内径（LAD）和左心室射血分数（LVEF），比较两组间Pmax、Pmin、Pd、LAD和LVEF的差异。结果：与对照组相比，观察组Pmax和Pd明显增大（P＜0.05），两组间Pmin、LAD和LVEF差异无统计学意义（P＞0.05），Pmax 110 ms+Pd≥40 ms预测房颤的敏感性及阴性预测值有所下降，但特异性和阳性预测值上升。结论：Pd是高血压合并阵发性房颤的预测因子，与Pmax联合应用预测价值更高。 [关键词] 高血压；心房颤动；P波离散度 [中图分类号] R544.1 [文献标识码]A[文章编号]1674-4721（2010）11（b）-005-02 Predictive value of P wave dispersion on paroxysmal atrial fibrillation of patients with essential hypertension CAO Feng, LI Xia (Department of Cardiology, the People′s Hospital of Wuhan University, Hubei Province, Wuhan 430060, China) [Abstract] Objective: To investigate the predictive value of P wave dispersion(Pd) on atrial fibrillation(AF) of patients with essential hypertension. Methods: Ninety-five patients were divided into two groups, including the essential hypertensive patients with(the observation group, n=48) or without AF(the control group, n=47). The maximum P wave duration (Pmax), the minimum P wave duration(Pmin) and Pd were measured in both groups through the 12-lead surface electrocardiogram. Left atrial dimension(LAD) and left ventricular ejection fraction(LVEF) were also measured by echocardiography. Pmax, Pmin, Pd, LAD and LVEF were compared between the two groups. Results: Compared with the control group, the observation group was significantly increased Pmax and Pd(P0.05), Pmax110 ms + Pd≥40 ms predict the sensitivity of atrial fibrillation and the negative predictive value decreased, but the specificity and positive predictive value increase. Conclusion: Pd is a significant predictor on AF in patients with essential hypertension. Its predictive value is higher when combined Pd and Pmax. [Key words] Hypertension; Atrial fibrillation; P wave dispersion 研究表明高血压患者易合并心房颤动（房颤），高血压不但是房颤的主要致病因素，也是房颤患者发生脑卒中的主要危险因素。高血压与房颤关系密切，预测高血压患者房颤的发生在临床上非常重要。P波离散度（P wave dispersion，Pd）是近年来发现的预测阵发性房颤的体表心电图的一个新指标，它反映心房不同部位的非均质性电活动。本研究旨在探讨Pd在高血压患