102例房性心律失常患者P波离散度特点分析.docVIP

102例房性心律失常患者P波离散度的特点分析 　　[摘要] 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（Pmax）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（Pmax），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Pmax[（111.4±7.2）ms vs （105.2±6.7）ms]均明显大于对照组（P均0.05）；与Pmax≥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Pmax≥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Pmax检测能提高对房性心律失常诊断的敏感度。 　　[关键词] P波离散度；P波最大时限；房性心律失常；临床特点 　　[中图分类号] R541.7 [文献标识码] A [文章编号] 1673-9701（2017）31-0009-03 　　[Abstract] Objective To investigate the predictive value of P-wave dispersion（Pd）and P-wave maximal time limit （Pmax）of body surface 12-lead ECG in atrial arrhythmia. Methods 102 patients with frequent premature beats and atrial tachycardia who were admitted to our hospital from October 2016 to January 2017 were selected as the atrial arrhythmia group. P-wave dispersion（Pd）and P-wave maximal time limit（Pmax）were measured and determined by 12-lead electrocardiogram synchronization test， and the results were compared with 106 healthy subjects（the control group）. Results The levels of Pd of [（41.5±5.2）ms vs （31.4±5.0）ms] and Pmax of [（111.4±7.2）ms vs （105.2±6.7）ms] in the atrial arrhythmia group were significantly higher than those in the control group（P0.05 for all）. The prediction of sensitivity of（85.3% vs 71.6%）， specificity of（85.9% vs 57.6%） and diagnostic compliance rate of （85.6% vs 64.4%） of atrial arrhythmia via Pd≥40 ms was higher than those of Pmax≥100 ms（P0.05 for all）. In the diagnosis by Pd ≥ 40 ms combined with Pmax≥100 ms， the sensitivity of （91.2% vs 85.3%） was increased， and the specificity of（53.8% vs 85.9%） and diagnostic compliance rate of（72.1% vs 85.6%） were decreased（P0.05 for all）. Conclusion Body surface electrocardiogram Pd is an effective index for predicting atrial arrhythm