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[心电图P波改变及其在儿童和青少年心脏抑制性血管迷走性晕厥中的诊断价值]

[Change in P wave on electrocardiogram and its diagnostic value in children and adolescents with cardioinhibitory vasovagal syncope].

作者信息

Wang Shuang-Shuang, Yi Xiu-Ying, Ji Qing, Wang Yu-Wen, Wang Cheng

机构信息

Department of Pediatric Cardiovasology, Children's Medical Center, Second Xiangya Hospital, Central South University, Changsha 410011, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2019 Nov;21(11):1084-1088. doi: 10.7499/j.issn.1008-8830.2019.11.006.

Abstract

OBJECTIVE

To study the change in P wave on electrocardiogram and its diagnostic value in children and adolescents with cardioinhibitory vasovagal syncope (VVS-CI).

METHODS

A total of 43 children and adolescents who were diagnosed with VVS-CI were enrolled as the VVS-CI group, and 43 healthy children and adolescents were enrolled as the control group. P wave duration and P wave voltage were measured by 12-lead electrocardiography in a basal state, and the changes were analyzed.

RESULTS

Compared with the control group, the VVS-CI group had a significantly lower heart rate (P<0.05) and significantly longer P wave duration (Pwd), P wave maximum duration (Pmax), and corrected P wave maximum duration (Pcmax), as well as significantly higher P wave dispersion (Pd) and corrected P wave dispersion (Pcd) (P<0.05). Pwd, Pmax, Pd, Pcmax and Pcd had a certain diagnostic value in children and adolescents with VVS-CI (P<0.05): Pwd had a sensitivity of 69.77% and a specificity of 83.72% at the optimal cut-off value of 78.49 ms; Pmax had a sensitivity of 76.74% and a specificity of 90.70% at the optimal cut-off value of 93.39 ms; Pd had a sensitivity of 95.35% and a specificity of 69.77% at the optimal cut-off value of 27.42 ms; Pcmax had a sensitivity of 46.51% and a specificity of 88.37% at the optimal cut-off value of 120.90 ms; Pcd had a sensitivity of 83.72% and a specificity of 72.09% at the optimal cut-off value of 36.37 ms.

CONCLUSIONS

Children and adolescents with VVS-CI have significantly increased Pwd, Pmax, Pd, Pcmax, and Pcd, which may indicate abnormal atrial electrical activity. The cut-off value of P wave has a certain diagnostic value in VVS-CI.

摘要

目的

研究心电图P波变化及其对儿童和青少年心脏抑制型血管迷走性晕厥(VVS-CI)的诊断价值。

方法

共纳入43例诊断为VVS-CI的儿童和青少年作为VVS-CI组,43例健康儿童和青少年作为对照组。采用12导联心电图在基础状态下测量P波时限和P波电压,并分析其变化。

结果

与对照组相比,VVS-CI组心率显著降低(P<0.05),P波时限(Pwd)、P波最大时限(Pmax)、校正P波最大时限(Pcmax)显著延长,P波离散度(Pd)和校正P波离散度(Pcd)显著升高(P<0.05)。Pwd、Pmax、Pd、Pcmax和Pcd对儿童和青少年VVS-CI有一定诊断价值(P<0.05):在最佳截断值78.49 ms时,Pwd的敏感性为69.77%,特异性为83.72%;在最佳截断值93.39 ms时,Pmax的敏感性为76.74%,特异性为90.70%;在最佳截断值27.42 ms时,Pd的敏感性为95.35%,特异性为69.77%;在最佳截断值120.90 ms时,Pcmax的敏感性为46.51%,特异性为88.37%;在最佳截断值36.37 ms时,Pcd的敏感性为83.72%,特异性为72.09%。

结论

VVS-CI儿童和青少年的Pwd、Pmax、Pd、Pcmax和Pcd显著增加,这可能提示心房电活动异常。P波截断值对VVS-CI有一定诊断价值。

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