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目的探讨V_1导联P波终末电势(P wave terminal force in lead V_1,PtfV_1)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PtfV_1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PtfV_1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Ptf V_1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],PtfV_1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,PtfV_1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PtfV_1值随LVEF的下降而下降。结论心功能不全患者的PtfV_1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,Ptf V_1可作为心功能不全严重程度的一项实用的评估指标。
Objective To investigate the clinical value of P wave terminal force in lead V_1 (PtfV_1) in patients with cardiac insufficiency and its correlation with left ventricular ejection fraction (LVEF). Methods Eighty-seven patients with congestive heart failure and 85 normal subjects admitted to our hospital were selected as experimental group and control group respectively. The PtfV_1 values on the body surface and the Echocardiographic LVEF values were calculated and compared between the two groups. At the same time, the change of PtfV_1 in the experimental group compared with control group PtfV slightly decreased (LVEF 40% ~ 50%), moderate decreased (LVEF 30% ~ 40%) and severe decreased The difference between V_1 values. Results The LVEF values of 1 experimental group were significantly lower than those of the control group [(37.32 ± 8.36)% vs (60.79 ± 6.56)%, P <0.05], and PtfV_1 values [-0.067 ± -0.021] mm · s vs. (-0.017 ± -0.009) mm · s, P <0.05]. 2 In the patients with mild, moderate and severe declines of LVEF, the values of PtfV_1 decreased in the order of [(-0.047 ± -0.007) mm · s - (-0.071 ± -0.010) mm · s - (-0.095 ± -0.013 ) mm · s], both of which were lower than that of the control group (P <0.05), indicating that PtfV_1 decreased with the decrease of LVEF. Conclusion The PtfV_1 value of patients with cardiac insufficiency decreased significantly with the decrease of LVEF, and positively correlated with the severity of cardiac insufficiency. Therefore, Ptf V_1 can be used as a practical assessment of the severity of cardiac insufficiency.