经皮球囊二尖瓣成形术对风湿性心脏病二尖瓣狭窄伴阵发性房颤患者P波离散度的影响

目的　探讨经皮球囊二尖瓣成形术 (PBMV)对风湿性心脏病二尖瓣狭窄伴阵发性房颤患者P波离散度的影响。方法　风湿性心脏病二尖瓣狭窄患者 90例。依据患者是否伴阵发性房颤分为两组。不伴阵发性房颤 (A组 ) 6 0例 ,伴阵发性房颤 (B组 ) 30例 ,均接受PBMV术 ,分别测量两组患者术前及术后 3个月P波最大时限 (Pmax)和P波离散度 (Pd)。结果　术前B组患者Pmax及Pd显著高于A组 (P <0 .0 1) ,术后 3个月B组患者Pmax及Pd较术前显著减低 (P <0 .0 1)。结论　Pmax及Pd可预测风湿性心脏病二尖瓣狭窄患者伴阵发性房颤的发生 ;PBMV术可改善心房电传导。降低风湿性心脏病二尖瓣狭窄伴阵发性房颤患者的Pmax及Pd。

The influence of percutaneous balloon mitral valvuloplasty on P wave dispersion in rheumatic mitral stenosis with paroxysmal atrial fibrillation

Objective To study the influence of percutaneous balloon mitral valvuloplasty(PBMV) on P wave dispersion in rheumatic mitral stenosis with paroxysmal atrial fibrillation(PAF).Methods 90 cases of rheumatic mitral stenosis were divided into two groups: group A(n=60 without RAF) and group B(n=30 with PAF),who underwent PBMV.Maximum P wave duration(Pmax) and P wave dispersion(Pd) were measured in the two groups.Results Pmax and Pd in group B were significantly higher than in group A before PBMV( P<0.01 ),which were significantly decreased 3 months after PBMV,compared with that before PBMV(P<0.01).Conclusion Because Pmax and Pd can predict the incidence of paroxysmal atrial fibrillation in the patients with rheumatic mitral stenosis,PBMV can improve atrial electrical transduction and decrease Pmax and Pd of the rheumatic mitral stenosis patients with paroxysmal atrial fibrillation.