P波离散度对原发性高血压伴阵发性心房颤动的临床价值

目的探讨P波离散度（Pd）对原发性高血压伴阵发性心房颤动（PAF）的临床价值。方法记录32例原发性高血压患者伴PAF者（A组）窦性心律时12导联心电图，分别测定最大P波时限（Pmax）、最小P波时限（Pmin）、P波离散度（Pd）、超声心动图测定左心房内径（LAD），与40例单纯原发性高血压者（B组）比较。统计Pd≥40ms、Pax≥120ms以及Pd≥40ms＋Pmax≥120ms阳性例数，计算PAF的灵敏性、特异性。结果Pmax：A组（125．84±17．7）ms显著高于B组（109．4±13．1）ms（P〈0．05）；Pd：A组（47．7±13．1）ms显著高于B组（31．4±11．6）ms（P〈0．05）；Pmin、In、LAD两组差别无统计学意义。单因素回归分析显示：Pmax、Pd、LAD是PAF的预测因子；多因素回归分析显示：Pd是PAF的独立预测因子。Pmax≥120ms预测的敏感性为87．5％，特异性为82．5％；Pd≥40ms预测的敏感性为81．3％，特异性为85％；Pmax〉100ms＋Pd≥40ms的敏感性为78．1％，特异性为87．5％。结论Pd是原发性高血压伴PAF的独立预测因子，与Pmax联合应用价值更高。

Clinical value of P wave dispersion on paroxysmal atrial fibrillation in primary hypertensive patients

Objective To investigate the clinical value of P wave dispersion(Pd) on paroxysmal atrial fibrillation(PAF) in primary hypertensive patients.Methods Seventy-two patients were divided into two groups,including the primary hypertensive patients with(Group A,n=32)or without PAF(GroupB,n=40).The maximum Pwave duration(Pmax),the minimum P wave duration(Pmin)and Pd based on the 12 lcad SUrface electrocardiogram were measured in both groups. Left atrial dimension(LA D) was also measured by echocardiography.The sensitivity,specificity and predicted positive rate of PAF were detected.Results Pmax in group A(125.8±17.7)ms was significantly higher than that in group B(109.4± 13.1)ms(P<0.05).Pd was changed in the same way as Pmax, Pd was(47.7 ±13.1)ms vs(31.4±11.6)ms,P<0.05.In univariate analysis,Pmax,Pd,LAD were significant predictors of PAF, whereas only Pd was a significant independent predictor of PAF in the multivariate analysis.Compared with the standard of Pmax ≥120 ms,Pd's sensitivity and specificity was 87.5% and 82.5%,when Pd≥40 ms,it was 81.3% and 85%,when Pmax ≥120ms and Pd≥40ms,it was 78.1% and 87.5%. Conclusion Pd is a significant independent predictor on PAF in primary hypertensive patients.It is better predictive value when use Pd and Pmax in it.