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目的探讨体表心电图P波离散度(Pwd)与阵发性房性心动过速的关系。方法阵发性房性心动过速患者36例为A组,测量其体表心电图的Pwd、P波最大时限(Pmax),并与45例健康对照组B组对比分析。以Pmax≥110ms和Pwd≥40ms为阳性标准,评估Pmax、Pwd和Pmax+Pwd对阵发性房性心动过速的预测价值。结果A组与B组比较Pmax、Pwd均较前差异有统计学意义(P<0.05),Pmax≥110ms时,预测阵发性房性心动过速的敏感性为85.6%,特异性为84.4%,特异性为89.7%,阳性预测值为85.9%:当Pmax≥110ms+Pwd≥40ms时,预测阵发性房性心动过速的敏感性为78.7%,特异性为91.5%,阳性预测值为90.2%。结论体表心电图Pwd是预测阵发性房性心动过速的有效指标,而当Pmax与Pwd两者相结合时阵发性房性心动过速的特异性和准确性更高。
Objective To investigate the relationship between P wave dispersion (Pwd) and paroxysmal atrial tachycardia in surface electrocardiogram. Methods Thirty-six patients with paroxysmal atrial tachycardia were divided into group A, Pwd and Pmax of body surface electrocardiogram were measured and compared with group B of 45 healthy controls. Pmax≥110ms and Pwd≥40ms were used as positive criteria to evaluate the predictive value of Pmax, Pwd and Pmax + Pwd in patients with paroxysmal atrial tachycardia. Results The Pmax and Pwd in group A and group B were significantly higher than those in group B (P <0.05). When Pmax≥110 ms, the sensitivity and the specificity of predicting paroxysmal atrial tachycardia were 85.6% and 84.4% , The specificity was 89.7% and the positive predictive value was 85.9%. When Pmax≥110ms + Pwd≥40ms, the sensitivity and specificity of predicting paroxysmal atrial tachycardia were 78.7% and 91.5% respectively. The positive predictive value was 90.2%. Conclusion Body surface electrocardiogram Pwd is an effective predictor of paroxysmal atrial tachycardia, whereas the specificity and accuracy of paroxysmal atrial tachyarrhythmias are higher when both Pmax and Pwd are combined.