【摘要】 目的评估缺铁性贫血(IDA)患者的P波离散度(PWD)以及PWD和超声心动图指标的相关性,探讨IDA对PWD和左心室舒张功能的影响。方法选择2012年3月—2013年8月在我院血液内科住院患者及体检中心体检人员共167例,其中IDA患者107例作为IDA组,健康者60例作为对照组。受试者均进行身高、体质量、血压等临床检查及血细胞、12导联心电图和经胸超声心动图等实验室检查,检测平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、铁粒幼红细胞、血清铁、血清铁蛋白、左心室快速充盈E峰值和左心房收缩A峰值、E/A、E峰减速时间(DT)、等容舒张时间(IVRT)、左心室射血分数(LVEF)、左心房直径(LAD)、左心室舒张末期直径(LVEDD)、左心室收缩末期直径(LVESD)、室间隔厚度(IVS)、后壁厚度(PW)、P波最大宽度(Pmax)及P波最小宽度(Pmin)等指标。结果 IDA组患者DT、IVRT和左心室舒张功能不全发生率高于对照组(P<0.05);而血红蛋白(Hb)、血细胞比容(HCT)、血清铁、血清铁蛋白、转铁蛋白饱和度均低于对照组(P<0.05)。IDA组患者PWD和心率均高于对照组(P<0.05);而两组间Pmax、Pmin比较,差异无统计学意义(P>0.05)。PWD与相关因素的分析结果显示,PWD与IDA、IVRT、DT和心率呈正相关(r=0.475、0.348、0.326、0.322,P<0.05);而与Hb水平呈负相关(r=-0.452,P<0.05);PWD与性别、年龄、LVEF、收缩压和舒张压无直线相关性。结论 IDA可使PWD增加,导致左心室舒张功能不全。故对IDA患者及时进行心电图检查,早期诊治左心室舒张功能不全,可有效降低心力衰竭的发生率,提高患者生活质量。更多还原

【Abstract】 Objective To evaluate the correlation of P wave dispersion(PWD) with echocardiography(ECG) indicators in patients with iron deficiency anemia(IDA),to determine the effects of IDA on PWD and left ventricular diastolic function. Methods One hundred and sixty-seven people in our hospital between March 2012 and August 2013 were included in this study. The height,weight,blood pressure(BP) were measured,auxiliary examinations of blood cells,12-lead ECG, transthoracic ECG carried out,and mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular-hemoglobin concentration(MCHC),sideroblasts,serum iron,serum ferritin,left ventricular rapid filling E-peak and left atrial contraction A-peak,E / A ratio,deceleration time(DT) of E-peak,isovolumic relaxation time(IVRT),left ventricular ejection fraction(LVEF),left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),interventricular septal thickness(IVS),posterior wall thickness(PW),P-wave maximum width(Pmax) and P-wave minimum width(Pmin) and other indicators were detected in 107 IDA patients and 60 healthy controls. Results DT,IVRT and incidence of left ventricular diastolic dysfunction were higher in IDA group than in control group(P < 0. 05),and hemoglobin(Hb),hematocrit(HCT),serum iron,serum ferritin,transferrin saturation lower(P < 0. 05). PWD and heart rate(HR) were higher in IDA group than in control group(P < 0. 05),but there was no significant difference in Pmax,Pmin between 2 groups(P > 0. 05). By correlation analysis,PWD was positively correlated with IDA,IVRT,DT,and HR(r = 0. 475,0. 348,0. 326,0. 322,P < 0. 05),negatively with Hb(r =-0. 452,P < 0. 05), not correlated with gender,age,LVEF,SBP,DBP. Conclusion IDA can make PWD increase and lead to left ventricular diastolic dysfunction. So timely ECG examination and early diagnosis and treatment of left ventricular diastolic dysfunction can reduce the incidence of heart failure effectively to improve patients’ quality of life.更多还原