【摘要】 目的探讨左心室舒张功能正常和左心室舒张功能不全(LVDD)不同发展阶段患者的P波离散度(PD)与左心室舒张功能之间的关系。方法应用12导联同步体表心电图和24h动态12导联同步心电图测量89例LVDD患者(LVDD组)和75例未合并LVDD患者(对照组)的最大P波宽度、最小P波宽度和PD。比较PD与LVDD的病因(分别为缺血性心脏病亚组、左心室肥厚亚组)、严重程度(分别为左心室充盈减低亚组、左心室充盈假性正常亚组和限制型充盈异常亚组)和超声心动图参数间的关系。结果 LVDD组的PD为(53.6±8.5)ms,显著高于对照组的(43.4±7.9)ms(P=0.002)。左心室充盈减低亚组、左心室充盈假性正常亚组和限制型左心室充盈异常亚组的PD分别为(48.4±6.3)、(54.5±7.2)和(58.1±8.5)ms,随着LVDD严重程度的增加,PD值有增加的趋势,但差异无统计学意义(P=0.08)。缺血性心脏病亚组的PD为(53.1±7.3)ms,左心室肥厚亚组为(52.2±8.4)ms,两组间的差异无统计学意义(P=0.28)。结论 LVDD患者的PD增加,PD可作为诊断LVDD的无创性指标之一。更多还原

【Abstract】 Objective To investigate the relationship between P wave dispersion and left ventricular diastolic function.Methods The maximum P wave duration,minimum P wave duration and P wave dispersion were measured by surface electrocardiogram in 89 patients with left ventricular diastolic dysfunction(LVDD,LVDD group)and 75 patients without LVDD(control group).The relationship between P wave dispersion and cause(ischemic heart disease and left ventricular hypertrophy),severity(insufficiency of left ventricular filling,false normal left ventricular filling and limited abnormal left ventricular filling),and echocardiographic measurements of LVDD were investigated.Results P wave dispersion of LVDD group was significantly longer than that of control group([53.6±8.5]ms vs.[43.4±7.9]ms,P=0.002).P wave dispersion was(48.4±6.3)ms,(54.5±7.2)ms and(58.1±8.5)ms in the patients with insufficiency of left ventricular filling,false normal left ventricular filling and limited abnormal left ventricular filling,respectively.P wave dispersion increased as LVDD became more severe,but the difference did not reach statistical significance(P=0.08).There was no significant difference in P wave dispersion between the patients with ischemic heart disease and with left ventricular hypertrophy([53.1±7.3]ms vs.[52.2±8.4]ms,P=0.28).Conclusion P wave dispersion may increase in patients with left ventricular diastolic dysfunction.Therefore,it can be taken as one of non-invasive indices for assessing left ventricular diastolic dysfunction.(Shanghai Med J,2014,37:577-580)更多还原