江山　周贝贝　王付



心电图V1导联P波终末电势与心功能不全的相关性研究

江山周贝贝王付

234000 安徽 宿州，皖北煤电集团总医院心电图科

[摘要]目的探讨V1导联P波终末电势(P wave terminal force in lead V1，PtfV1)对心功能不全患者的临床价值及其与左室射血分数(left ventricular ejection fraction，LVEF)的相关性。方法选择我院心内科收治的87例心功能不全患者及85例正常体检者分别作为试验组和对照组。测量、计算入选者的体表心电图PtfV1值和超声心动图LVEF值，比较这两项指标在两组间的差异。同时，比较试验组PtfV1值在LVEF轻度下降(LVEF 40%～50%)、中度下降(LVEF 30%～40%)及重度下降(LVEF<30%)时的变化及其与对照组PtfV1值之间的差异。结果① 试验组的LVEF值显著低于对照组[(37.32±8.36)% vs.(60.79±6.56)%，P<0.05]，PtfV1值亦然[(-0.067±-0.021)mm·s vs.(-0.017±-0.009)mm·s，P<0.05]。② 在LVEF轻度、中度和重度下降的试验组患者中，PtfV1值依次降低[(-0.047±-0.007)mm·s—(-0.071±-0.010)mm·s—(-0.095±-0.013)mm·s]，且均低于对照组，差异均有统计学意义(P<0.05)，说明PtfV1值随LVEF的下降而下降。结论心功能不全患者的PtfV1值随着LVEF值的下降明显下降，且与心功能不全的严重程度呈正相关。因此，PtfV1可作为心功能不全严重程度的一项实用的评估指标。

[关键词]V1导联P波终末电势；心功能不全；左室射血分数[中图分类号]R541.7；R540.41

[文献标志码]A

[文章编号]2095-9354(2016)03-0201-03

The relativity between P wave terminal force in lead V1and cardiac insufficiencyJiangShan,ZhouBei-bei,WangFu(Department of Electrocardiogram, Wanbei Coal Electricity Group Central Hospital, Suzhou Anhui 234000, China)[Abstract]ObjectiveTo investigate the clinical value of P wave terminal force in lead V1(PtfV1) among patients with cardiac insufficiency and the relationship between PtfV1and left ventricular ejection fraction (LVEF). MethodsA total of 87 patients with cardiac insufficiency were selected as experimental group who had been admitted by the department of cardiology in our hospital. Another 85 cases of healthy people were enrolled as control group. We measured and calculated their PtfV1in body surface ECG and LVEF in echocardiogram. The differences of the two indices were compared between experimental and control groups. At the same time, we compared the changes of PtfV1in experimental group with mild, moderate and severe decline of LVEF[(40-50)%,(30-40)%, and (<30%)] respectively as well as the index separately between the three subgroups in experimental group and control group. Results(i) The LVEF value of experimental group was significantly lower than that of control group[(37.32±8.36)%vs. (60.79±6.56)%,P<0.05], and so was PtfV1value[(-0.067±-0.021) mm·svs. (-0.017±-0.009) mm·s,P<0.05].(ii) Among the patients separately with mild, moderate and severe decline of LVEF, PtfV1value orderly decreased[(-0.047±-0.007) mm·s, (-0.071±-0.010) mm·s, and (-0.095±-0.013) mm·s]. The PtfV1value in each of the three subgroups was lower than that in control group, with statistically significant difference(P<0.05). It indicated that PtfV1reduced with the decrease of LVEF. ConclusionIn the patients with cardiac insufficiency, PtfV1declines significantly with the decrease of LVEF and the index is positively correlated with the severity of cardiac insufficiency. Therefore,PtfV1can be applied in evaluating the severity of cardiac insufficiency as a practical index.[Key words]P wave terminal force in lead V1; cardiac insufficiency; left ventricular ejection fraction

体表心电图上V1导联P波终末电势(P wave terminal force in lead V1，PtfV1)又称Morris指数，由Morris等[1]于1964年首次报道，是指体表心电图V1导联P波呈正负双向时，终末负向P波时间与振幅的乘积。PtfV1不仅能够反映早期左房结构异常，而且在某种程度上与左心室的舒张功能相关[2]。本文通过分析PtfV1值与心功能不全的关系及其与LVEF值的关联，旨在探讨PtfV1对心功能不全严重程度的预测价值。

1资料与方法

1.1一般资料

选取2013年1月至2015年12月经我院心内科诊治的87例心功能不全患者作为试验组，其中男54例、女33例，平均(60.72±5.61)岁，均符合Framingham慢性心力衰竭的诊断标准。对照组为85例同期进行健康体检的无器质性心脏病且心功能正常者，其中男59例、女26例，平均(58.71±4.69)岁。所有病例的基本心律均为窦性心律。两组的年龄、性别等一般资料比较，差异均无统计学意义(P>0.05)。

1.2研究方法

所有入选者采取平卧位，采用日本光电9130P型心电图机采集12导联同步心电图，并将所有心电信息传入光电心电信息管理系统。以……