P波离散度对孤立性阵发性房颤发生的预测价值

麻友键

（陕西省汉中市镇巴县医院心血管内科，陕西 汉中，723600）

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摘要：

目的 观察心电图P 波离散度（Pd）与孤立性阵发性房颤发生的关系，分析Pd 预测房颤发生的价值及可能机制。方法 分析收治的50 例孤立性阵发性房颤（房颤组）患者最长P 波时限（Pmax）、最短P 波时限（Pmin）、P 波离散度（Pd）、左房内径（LAD），与50 例基线资料相匹配的窦性心律患者（对照组）进行比较，同时分析房颤组Pd 与LAD 的相关性。计算Pd 和Pmax 检测阵发性心房颤动的敏感度、特异度、阳性预测值及阴性预测值。结果 房颤组Pmax、Pd 及LAD 明显大于对照组（P<0.05），孤立性阵发性房颤患者Pd 与LAD 呈正相关（P<0.05）。Pmax>110 ms 预测孤立性阵发性房颤发生的敏感度为70.00%，特异度 为60.00%，阳性预测值为63.64%，阴性预测值为66.67%；Pd≥40 ms 预测孤立性阵发性房颤的敏感度为66.00%，特异度为 80.00%，阳性预测值为76.74%，阴性预测值为70.18%。Pmax>110 ms 和Pd≥40 ms 联合预测孤立性阵发性房颤的敏感度为 40.00%，特异性为90.00%，阳性预测值为80.00%，阴性预测值为60.00%。结论 体表心电图Pd 是预测孤立性阵发性房颤较 为有效、无创、方便的体表心电图指标。

关键词：P 波离散度；阵发性房颤；心电图

中图分类号：R541.75文献标志码：A文章编号：2096-1413(2018)06-0001-03

The value of P-wave dispersion for prediction of lone paroxysmal atrial fibrillation


MA You-jian
(Cardiovascular Medicine Department, the Hospital of Zhenba County, Hanzhong 723600, China)

ABSTRACT: Objective To observe the relationship between the electrocardiogram P-wave dispersion (Pd) and occurrence of lone paroxysmal atrial fibrillation, and the value and possible mechanism of Pd for prediction lone atrial fibrillation was analysed. Methods The maximum P-wave duration (Pmax), minimum P-wave duration (Pmin), P-wave dispersion (Pd) and left atrial fibrillation diameter (LAD) in 50 patients with lone paroxysmal atrial fibrillation (atrial fibrillation group, AF group) was analyzed, and compared with 50 cases of sinus rhythm patients (control group) whose clinical data were paired. The correlation of Pd and LAD in AF group was analyzed. The sensitivity, specificity, positive predictive value and negative predictive value of Pd and Pmax were calculated for prediction of lone paroxysmal atrial fibrillation. Results Compared with the control group, AF group showed increased Pmax, Pd and LAD (P<0.05). Pd and LAD was positive correlation in AF group (P<0.05). The Pmax >110 ms and Pd ≥40 ms for prediction of lone paroxysmal atrial fibrillation showed a sensitivity of 70.00% and 66.00%, a specificity of 60.00% and 80.00%, positive predictive value of 63.64% and 76.74%, and negative predictive value of 66.67% and 70.18%. Pmax >110 ms and Pd>40 ms in predicting solitary paroxysmal atrial fibrillation showed a sensitivity of 40.00%, a specificity of 90.00%, positive predictive value of 80.00% and negative predictive value of 60.00%. Conclution In surface electrocardiogram, Pd is a relatively effective, non-invasive and convenient indicators for prediction of the lone paroxysmal atrial fibrillation.
KEYWORDS: P-wave dispersion; paroxysmal atrial fibrillation; electrocardiogram

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