P波离散度及心钠素与房性心律失常的关系研究

目的:探讨阵发性房颤和房性早搏患者的P波离散度(Pd)?左房内径(LAD)和心钠素(ANP)水平的变化及其相关性?方法:共入选阵发性房颤患者40例(A组),频发房性早搏患者50例(B组),正常对照组50例(C组),分别查窦性心律时的12导联心电图,测量最大P波时限(Pmax)及最小P波时限(Pmin)并计算P波离散度(Pd=Pmax-Pmin),超声心动图测量LAD;并取空腹静脉血用放免法测ANP水平?结果:阵发性房颤及频发房性早搏组的LAD?Pmax?Pd?ANP与对照组相比均明显延长(P < 0.01);阵发性房颤组与频发房性早搏组相比也有显著性差异(P < 0.05);LAD与Pmax?Pd?ANP均呈正相关(r=0.366,r=0.299,r=0.388,P < 0.01),ANP与Pmax?Pd也呈正相关(r=0.330,r=0.215,P < 0.01);而 Pmax与Pd相关性最好(r=0.706,P < 0.01)?结论: LAD?Pmax?Pd?ANP均与房性心律失常密切相关?

The relationship between P wave dispersion,atrial natriuretic peptide and atrial arrhythmia

Objective:To study the relationship of P wave dispersion (Pd),left atrial dimension(LAD) and atrial natriuretic peptide (ANP) between patients with paroxysmal atrial fibrillation and those with atrial premature beats. Methods:40 patients with paroxysmal atrial fibrillation(group A),50 patients with atrial premature beats(group B)and 50 healthy controls(group C) were included. The P wave maximal duration (Pmax) and the minimum duration(Pmin) and P wave dispersion(Pd=Pmax-Pmin)were measured using 12 leads electrocardiogram.Left atrial dimension(LAD)was measured by the echocardiogram and ANP was detected by radioimmunoassay(RIA) in each individule. Results:LAD,Pmax,Pd and ANP were higher significantly in patients with paroxysmal atrial fibrillation and atrial premature beats than those in healthy controls(P < 0.01);The significant difference also existed between patients with paroxysmal atrial fibrillation and those with atrial premature beats(P < 0.05);Pmax,Pd and ANP were all correlated with LAD(r=0.366,r=0.299,r=0.388,P < 0.01)and the best correlation was shown between Pmax and Pd(r=0.706,P < 0.01);Pmax and Pd had correlation with ANP (r=0.330,r=0.215,P < 0.01). Conclusion:LAD,Pmax,Pd and ANP are closely related to atrial arrhythmia.