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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。
Objective To investigate the effect of percutaneous balloon mitral valvuloplasty (PBMV) on P wave dispersion in rheumatic mitral stenosis with paroxysmal atrial fibrillation. Methods 90 patients with rheumatic mitral stenosis. According to whether patients with paroxysmal atrial fibrillation are divided into two groups. 60 patients with paroxysmal atrial fibrillation (group A) and 30 patients with paroxysmal atrial fibrillation (group B) received PBMV. The maximum time of P wave in both groups before and 3 months after operation (Pmax) and P wave dispersion (Pd). Results Pmax and Pd in group B before operation were significantly higher than those in group A (P <0.01). Pmax and Pd in group B at 3 months after operation were significantly lower than those before operation (P <0.01). Conclusion Pmax and Pd can predict the occurrence of paroxysmal atrial fibrillation in rheumatic mitral stenosis patients. PBMV can improve the atrial electrical conduction. Reduce Pmax and Pd in patients with rheumatic mitral stenosis and paroxysmal atrial fibrillation.