中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
7期
881-883
,共3页
心房颤动%心房%P波离散度
心房顫動%心房%P波離散度
심방전동%심방%P파리산도
Atrial fibrillation%Heart atrium%P wave dispersion
目的 探讨P波离散度(Pd)、最大P波时限(Pmax)及左心房大小对阵发性心房颤动(PAF)的预测价值.方法 采用12导联同步心电图机记录160例PAF患者(PAF组)的Pd及Pmax,超声心动图仪测量左心房舒张末期内径(LAD),并与160例非PAF患者(对照组)比较.结果 与对照组比较,PAF组的Pd[(47±9)ms比(33±4)ms]增大、Pmax[(123±14) ms比(104±11)ms]明显延长,LAD [(4.2±0.6)cm比(3.5±0.4)cm]明显增大(P＜0.05).Pd、Pmax与LAD在不同病因PAF患者中差异无统计学意义(P＞0.05).直线相关分析显示Pd及Pmax与LAD呈显著正相关(r分别为0.426、0.558,P＜0.05).Pmax≥110 ms时,预测PAF的敏感性、特异性和阳性预测值分别为81.9％、73.8％和75.7％；Pd≥40 ms时,其敏感性、特异性和阳性预测值分别为81.3％、82.5％和82.3％；当联合Pmax≥110 ms且Pd≥40 ms时,敏感性为74.4％,特异性为91.3％,阳性预测值为89.5％.以LAD≥4.0 cm为左心房扩大诊断标准,则其预测PAF的灵敏度、特异性和阳性预测值分别为68.1％、65.6％和66.5％.结论 Pd、Pmax与PAF患者左心房大小显著相关,均可作为预测PAF的体表心电图指标,联合应用可提高特异性和阳性预测值.
目的 探討P波離散度(Pd)、最大P波時限(Pmax)及左心房大小對陣髮性心房顫動(PAF)的預測價值.方法 採用12導聯同步心電圖機記錄160例PAF患者(PAF組)的Pd及Pmax,超聲心動圖儀測量左心房舒張末期內徑(LAD),併與160例非PAF患者(對照組)比較.結果 與對照組比較,PAF組的Pd[(47±9)ms比(33±4)ms]增大、Pmax[(123±14) ms比(104±11)ms]明顯延長,LAD [(4.2±0.6)cm比(3.5±0.4)cm]明顯增大(P＜0.05).Pd、Pmax與LAD在不同病因PAF患者中差異無統計學意義(P＞0.05).直線相關分析顯示Pd及Pmax與LAD呈顯著正相關(r分彆為0.426、0.558,P＜0.05).Pmax≥110 ms時,預測PAF的敏感性、特異性和暘性預測值分彆為81.9％、73.8％和75.7％；Pd≥40 ms時,其敏感性、特異性和暘性預測值分彆為81.3％、82.5％和82.3％；噹聯閤Pmax≥110 ms且Pd≥40 ms時,敏感性為74.4％,特異性為91.3％,暘性預測值為89.5％.以LAD≥4.0 cm為左心房擴大診斷標準,則其預測PAF的靈敏度、特異性和暘性預測值分彆為68.1％、65.6％和66.5％.結論 Pd、Pmax與PAF患者左心房大小顯著相關,均可作為預測PAF的體錶心電圖指標,聯閤應用可提高特異性和暘性預測值.
목적 탐토P파리산도(Pd)、최대P파시한(Pmax)급좌심방대소대진발성심방전동(PAF)적예측개치.방법 채용12도련동보심전도궤기록160례PAF환자(PAF조)적Pd급Pmax,초성심동도의측량좌심방서장말기내경(LAD),병여160례비PAF환자(대조조)비교.결과 여대조조비교,PAF조적Pd[(47±9)ms비(33±4)ms]증대、Pmax[(123±14) ms비(104±11)ms]명현연장,LAD [(4.2±0.6)cm비(3.5±0.4)cm]명현증대(P＜0.05).Pd、Pmax여LAD재불동병인PAF환자중차이무통계학의의(P＞0.05).직선상관분석현시Pd급Pmax여LAD정현저정상관(r분별위0.426、0.558,P＜0.05).Pmax≥110 ms시,예측PAF적민감성、특이성화양성예측치분별위81.9％、73.8％화75.7％；Pd≥40 ms시,기민감성、특이성화양성예측치분별위81.3％、82.5％화82.3％；당연합Pmax≥110 ms차Pd≥40 ms시,민감성위74.4％,특이성위91.3％,양성예측치위89.5％.이LAD≥4.0 cm위좌심방확대진단표준,칙기예측PAF적령민도、특이성화양성예측치분별위68.1％、65.6％화66.5％.결론 Pd、Pmax여PAF환자좌심방대소현저상관,균가작위예측PAF적체표심전도지표,연합응용가제고특이성화양성예측치.
Objective To explore the predictive value of P wave dispersion (Pd),the maximum P wave duration (Pmax) and left atrial size of paroxysmal atrial fibrillation (PAF).Methods 12-lead synchronous ECG and ultrasonic cardiograph were used to measure the Pd,Pmax and left atrial diameter(LAD) of 160 PAF patients (PAF group),and 160 patients without PAF were analyzed as control group.Results Compared with the control group,Pd[(47 ±9)ms vs (33 ± 4)ms],Pmax[(123 ± 14)ms vs (104 ± 11)ms],and LAD [(4.2 ± 0.6)cm vs (3.5 ± 0.4) cm] of PAF group were significantly prolonged (P ＜ 0.05).Pd,Pmax and LAD were similar in patients with PAF result form with a different etiology (P ＞ 0.05).Linear correlation analysis showed that Pd and Pmax had significant positive correlation with LAD (r =0.426,0.558,P ＜ 0.05).The sensitivity,specificity,accuracy,positive predictive value of Pmax≥110 ms for PAF were 81.9％,73.8％ and 75.7％ ;those of Pd≥40 ms were 81.3％,82.5％ and 82.3％.When combined with Pmax≥ 110 ms and Pd ≥40 ms,the sensitivity was 74.4％,the specificity was 91.3％ and the positive predictive value was 89.5％.The prediction of PAF sensitivity,specificity and positive predictive value were 68.1％,65.6％ and 66.5％,respectively,according to LAD acuity 4.0 cm for left atrium enlarge diagnostic criteria.Conclusion Pd and Pmax are significantly correlated with left atrial size of PAF patients,regardless of different etiology.Both of Pd and Pmax are predictive index of PAF and combined application can improve the specificity and positive predictive value.
