心电图V1导联P波终末电势与HATCH评分的相关性分析

目的 通过分析心电图V1导联P波终末电势（PTFV1）与阵发性心房颤动（房颤）进展风险评估指标（HATCH评分）的相关性,为阵发性房颤患者进展风险提供新的预测指标.方法 回顾并测量大连医科大学附属第一医院2011年至2012年180例非瓣膜性阵发性房颤患者的HATCH评分及PTFV1,使用Spearman等级相关分析PTFV1与HATCH评分的相关性.结果 ①180例非瓣膜性阵发性房颤患者PTFV1与HATCH评分呈显著正相关（r=0.550,P＜0.01）;②HATCH评分1分组PTFV1略大于HATCH评分0分组,但差异无统计学意义（P＞0.05）;HATCH评分≥2分组PTFV1明显大于HATCH评分1分组,差异有统计学意义（P＜0.01）;③平均随访1年,由阵发性房颤进展的持续性房颤患者（进展组）HATCH评分及PTFV1明显大于仍为阵发性房颤患者（阵发组）,差异有统计学意义（分别为P＜0.05,P＜0.01）;④PTFV1为0.07mm·s是ROC曲线上的最佳临界点,其预测房颤进展风险的敏感性为70％、特异性为81.8％,曲线下面积为0.876.结论 PTFV1作为一种无创检查指标对预测阵发性房颤向持续性房颤进展有重要的临床指导意义.

Correlation analysis of P-wave terminal force in lead V1 with HATCH score

Objective By analyzing the correlation of P-wave terminal force in lead Vl （ PTFV1 ） and paroxysmal atrial fibrillation progression risk assessment indicators （HATCH score）, to provide a new predic- tion method of risk of progression in patients with paroxysmal atrial fibrillation. Methods We reviewed and measured HATCH score and PTFVl in 180 hospital patients with non-valvular paroxysmal atrial fibrillation and analyzed the correlation of PTFV1 and HATCH score by using Spearman rank. Results （1）A positive correla- tion was observed between PTFV1 and HATCH score（ r= 0. 550,P〈0. 01 ） in 180 non-valvular paroxysmal atrial fibrillation patients.（2）The PTFV1 in group with HATCH score 1 was slightly larger than that in group with HATCH score 0,but no statistic difference （P〉0.05） ;PTFV1 in the group with HATCH score I〉2 was signifi- cantly higher than that in the group with HATCH score 1（P〈0.01）.（3）After an average of 1 year follow-up, HATCH score and PTFV1 in patients with progression from paroxysmal to persistent atrial fibrillation （progres- sive group） was significantly higher than that in patients without progression （paroxysmal group） （P〈0. 05 and P〈0. 01）.（4）PTFV1 was 0. 07 mm s as the best critical point on the ROC curve,the sensitivity of the predic- ting risk of progression was 70%, the specificity was 81.8%, the area under the curve was 0. 876, the difference comparing with Az = 0. 5 was statistically significant （P〈0. 01 ）. Conclusion PTFV1 as a noninvasire indicator of predicting progression of paroxysmal atrial fibrillation to persistent atrial fibrillation had important clinical significance.