持续性房颤射频消融术后p波时限及离散度与术后复发的关系

《持续性房颤射频消融术后p波时限及离散度与术后复发的关系》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、授予单位代码1008920学号或申请号20153104中国图书分类号R541.7+5HebeiMedicalUniversity硕士学位论文专业学位持续性房颤射频消融术后P波时限及离散度与术后复发的关系研究生：刘亚宁导师：谢瑞芹教授专业：内科学二级学院：河北医科大学第二医院2018年3月目录中文摘要················································································1英文摘要····················································

2、····························2英文缩写··············································································4研究论文持续性房颤射频消融术后P波时限及离散度与术后复发的关系前言··············································································5材料与方法··························································

3、···········5结果··············································································7附图··············································································9附表··············································································10讨论·····························

4、·················································15结论··············································································18参考文献········································································18综述心房颤动的预测因子：心电图的重要性································25致谢·····················

5、································································39个人简历··············································································40中文摘要持续性房颤射频消融术后P波时限及离散度与术后复发的关系摘要目的:探讨射频消融术后P波时限及离散度与持续性房颤术后早期与晚期复发的关系。方法：我们选择了80名首次行射频消融的持续性房颤患者（46名男性，34名女性;平均年龄60.6±8.1岁），随访9.3±2.9个月，

6、分为2个对比组：早期复发与早期未复发组，晚期复发与晚期未复发组。定义三个月内的复发为早期复发；三个月后的复发为晚期复发。所有患者手术后24小时内均记录12导联心电图。测量12导联的P波时限，计算出最大P波时限（Pmax），最小P波时限（Pmin），Pmax和Pmin之间的差异所得的P波离散度（Pd）。并定期随访，观察这些患者术后早期和晚期的复发率。结果：有17例患者出现早期复发，与早期未复发组比较,Pd明显增大(74.35±17.78对60.73±18.37P=0.008)；在以后随访期间有12例早期复发患者（70.6%）出现延迟恢复，未发现早期复发为晚期复发预测因子

7、；共14例患者出现晚期复发，与晚期未复发组对比，Pd明显增大（75.71±16.49对61.06±18.59P=0.008），Pd的ROC曲线下面积为0.728，通过观察不同的临界值，发现Pd≥60ms对预测持续性房颤术后晚期复发有一定价值，其敏感度85%、特异度50%、阳性预测值26.7%、阴性预测值94.3%。结论：Pd与持续性房颤术后早期及晚期复发有关，其中Pd≥60ms对预测持续性房颤术后晚期复发有一定的价值，其中阴性预测价值更高。关键词：持续性心房颤动,射频消融术,最大P波时限,最小P波时限,P波离散度1英文摘要P-waveduration