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目的探讨心电图V1导联P波终末电势(P-terminal force,Ptf V1)与慢性心力衰竭(CHF)及心律失常的关系。方法选择2014年1-12月在天津市第三中心医院分院心内科住院的CHF患者83例为CHF组,年龄(72.3±5.3)岁,其中男性40例,女性43例,依据美国纽约心脏病学会(NYHA)心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ分级标准,将CHF患者分为4个亚组。选择同期50例健康体检者[(70.5±5.2)岁]为对照组,两组均常规行12导联心电图检查计算Ptf V1值,并进行对比分析和CHF组Ptf V1值与心功能分级相关性检验。两组病例行24 h动态心电图检查,对心律失常情况和Ptf V1值进行相关分析,计算CHF组各亚组的心律失常发生率。结果 CHF组的Ptf V1值[(0.047±0.018)mm·s]明显高于对照组[(0.007±0.006)mm·s],差异有统计学意义(P<0.05);CHF组各亚组间比较(其中Ⅰ组和Ⅱ组Ptf V1比较虽有所增加,但差异无显著性),Ptf V1值随着心功能分级的增加而明显升高,差异有统计学意义(F=32.732,P<0.05)。Ptf V1值与心功能分级呈正相关(r=0.732,P<0.01)。随着心功能分级的增加,心律失常率[包括房性早搏、室性早搏、阵发房扑、阵发房颤、交界区早搏和(或)房室传导阻滞]有逐渐增加的趋势,差异有统计学意义(P<0.01)。Ptf V1值越大,心率失常发生率越高(r=0.422,P<0.05)。结论 CHF及心律失常与Ptf V1值具有相关性,其可以作为评价CHF患者心功能水平的可靠指标,并对临床预测CHF患者发生心律失常具有一定的预测价值。
Objective To investigate the relationship between P-terminal force (Ptf V1) and chronic heart failure (CHF) and arrhythmia in V1 lead of ECG. METHODS: From January to December 2014, 83 CHF patients hospitalized in Department of Cardiology, Third Central Hospital of Tianjin, CHF, aged 72.3 ± 5.3 years, 40 males and 43 females, (NYHA) cardiac function Ⅰ, Ⅱ, Ⅲ, Ⅳ grading standards, the CHF patients were divided into 4 subgroups. Fifty healthy subjects [(70.5 ± 5.2) years] of the same period were selected as the control group. The Ptf V1 values of 12-lead electrocardiogram were routinely calculated in both groups, and the correlation between Ptf V1 value and cardiac function grade was analyzed test. Two groups of patients underwent 24 h dynamic electrocardiogram examination, arrhythmia and Ptf V1 values were analyzed, the incidence of arrhythmia in each subgroup CHF group was calculated. Results The Ptf V1 value in CHF group was significantly higher than that in control group [(0.047 ± 0.018) mm · s) [(0.007 ± 0.006) mm · s) (P <0.05) (Group Ⅰ and group Ⅱ Ptf V1 comparison, although there was no significant difference, Ptf V1 value increased with the increase of cardiac function was significantly higher, the difference was statistically significant (F = 32.732, P < 0.05). There was a positive correlation between Ptf V1 and heart function (r = 0.732, P <0.01). Arrhythmia rates (including atrial premature beats, premature ventricular contractions, paroxysmal atrial flutter, paroxysmal atrial fibrillation, borderline premature beats and / or atrioventricular block) tended to increase with an increase in cardiac function, The difference was statistically significant (P <0.01). The larger the Ptf V1 value, the higher the rate of arrhythmia (r = 0.422, P <0.05). Conclusions CHF and arrhythmia are correlated with Ptf V1 value, which can be used as a reliable index to evaluate the cardiac function of patients with CHF, and have certain predictive value for the clinical prediction of cardiac arrhythmia in CHF patients.