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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。
Objective: To investigate the changes of P wave dispersion (Pd), left atrial appendage (LAD) and atrial natriuretic peptide (ANP) levels in patients with paroxysmal atrial fibrillation and atrial premature beats. Methods: A total of 40 patients with paroxysmal atrial fibrillation (group A), 50 patients with frequent atrial premature beats (group B) and 50 normal controls (group C) were enrolled in this study. (Pmax) and the minimum P wave time (Pmin) were measured, and the P wave dispersion (Pd = Pmax-Pmin) was calculated. The LAD was measured by echocardiography. The level of ANP was measured by radioimmunoassay. Results: The LAD, Pmax, Pd and ANP in patients with paroxysmal atrial fibrillation and frequent atrial premature beats were significantly prolonged compared with the control group (P <0.01). In patients with paroxysmal atrial fibrillation and frequent atrial premature beat, (P <0.05). There was a positive correlation between LAD and Pmax, Pd and ANP (r = 0.366, r = 0.299, r = 0.388, P <0.01) 0.330, r = 0.215, P <0.01). The correlation between Pmax and Pd was the best (r = 0.706, P <0.01). Conclusion: LAD, Pmax, Pd, ANP are closely related to atrial arrhythmia.