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山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (2): 52-55.doi: 10.6040/j.issn.1671-7554.0.2014.235

• 临床医学 • 上一篇    下一篇

代谢综合征与P波离散度关系的探讨

张风雷, 郑曼, 张琦, 顾磊, 徐新生   

  1. 东营市人民医院心内科, 山东 东营 257091
  • 收稿日期:2014-04-17 发布日期:2015-02-10
  • 通讯作者: 徐新生. E-mail:xinshengxu163@163.com E-mail:xinshengxu163@163.com
  • 基金资助:
    山东省医药卫生科技发展计划项目(2013WS0031)

Clinical study on the association between metabolic syndrome and P wave dispersion

ZHANG Fenglei, ZHENG Man, ZHANG Qi, GU Lei, XU Xinsheng   

  1. Department of Cardiology, Dongying People's Hospital, Dongying 257091, Shandong, China
  • Received:2014-04-17 Published:2015-02-10

摘要: 目的 探讨代谢综合征及相关指标对P波离散度(Pd)的影响,揭示代谢综合征的促心律失常作用.方法 选取代谢综合征患者86例,对照组102例,均行12导联同步体表心电图描记,分别测量最大P波时限(Pmax)、最小P波时限(Pmin)及Pd.结果 与对照组相比,代谢综合征组Pd明显增高(47.31±12.18 vs 33.08±11.04, P=0.001),但Pmax和Pmin无明显差异(P>0.05).相关分析显示,Pd与体质量指数(BMI, P=0.001)、总胆固醇(TC, P=0.038)、甘油三酯(TG,P=0.001)、载脂蛋白B(Apo B, P=0.027)、收缩压(SBP,P=0.036)及舒张压(DBP,P=0.015)呈正相关性.多元回归分析显示,BMI(P=0.001)与Pd存在明显的关联性.结论 BMI是影响Pd大小的独立危险因素,控制代谢综合征及体质量指数为心律失常防治提供一种新的策略,尤其是心房颤动.

关键词: P波离散度, 心电图, 代谢综合征, 心房颤动

Abstract: Objective To investigate the effect of metabolic syndrome on P wave dispersion (Pd), in order to reveal its proarrhythmic effect. Methods A total of 86 patients with metabolic syndrome and 102 controls were enrolled in the study. The maximum P wave duration (P max) and minimum P wave duration (P min) were measured with 12-lead synchronous surface electrocardiogram (ECG), and Pd was calculated using P max minus P min. Results Compared with the controls, patients had significantly higher value of Pd (47.31±12.18 vs 33.08±11.04, P=0.001). However, there was no much difference in P max and P min between the two groups (P>0.05). Correlation analyses revealed positive correlation between Pd and body mass index (BMI, P=0.001), total cholesterol (TC, P=0.038), triglyceride (TG, P=0.001), apolipoprotein B (Apo B, P=0.027), systolic blood pressure (SBP, P=0.036) and diastolic blood pressure (DBP, P=0.015). Multiple linear regression analysis indicated distinct association between BMI and Pd (P=0.001). Conclusion BMI is an independent influencing factor of Pd. Controlling metabolic syndrome and BMI will provide a new approach for the prevention and treatment of arrhythmia, especially atrial fibrillation.

Key words: P wave dispersion, Metabolic syndrome, Atrial fibrillation, Electrocardiogram

中图分类号: 

  • R543.3
[1] Watanabe H, Tanabe N, Watanabe T, et al. Metabolic syndrome and risk of development of atrial fibrillation: the Niigata preventive medicine study[J]. Circulation, 2008, 117(10):1255-1260.
[2] Başar N, Malçok Gürel O, Ozcan F, et al. Diagnostic accuracy of P-wave dispersion in prediction of maintenance of sinus rhythm after external cardioversion of atrial fibrillation[J]. Anadolu Kardiyol Derg, 2011, 11(1):34-38.
[3] Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease:a meta-analysis[J]. Am J Med, 2006, 119(10):812-819.
[4] Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis[J]. J Am Coll Cardiol, 2010, 56(14):1113-1132.
[5] Nguyen NT, Nguyen XM, Wooldridge JB, et al. Association of obesity with risk of coronary heart disease: findings from the national health and nutrition examination survey, 1999-2006[J]. Surg Obes Relat Dis, 2010, 6(5):465-469.
[6] Menezes AR, Lavie CJ, Dinicolantonio JJ, et al. Cardiometabolic risk factors and atrial fibrillation[J]. Rev Cardiovasc Med, 2013, 14(2-4):73-81.
[7] Nguyen JT, Benditt DG. Atrial fibrillation susceptibility in metabolic syndrome: simply the sum of its parts[J] .Circulation, 2008, 117(10):1249-1251.
[8] Bissinger A, Grycewicz T, Grabowicz W, et al. The effect of diabetic autonomic neuropathy on P-wave duration, dispersion and atrial fibrillation[J]. Arch Med Sci, 2011, 7(5):806-812.
[9] Tadic M, Ivanovic B, Cuspidi C. What do we currently know about metabolic syndrome and atrial fibrillation[J]. Clin Cardiol, 2013, 36(11): 654-662.
[10] Dentali F, Romualdi E, Ageno W. The metabolic syndrome and the risk of thrombosis[J]. Haematologica, 2007, 92(9): 297-299.
[11] Dilaveris P, Batchvarov V, Gialafos J, et al. Comparison of different methods for manual P wave duration measurement in 12-lead electrocardiograms[J]. Pacing Clin Electrophysiol, 1999, 22(10):1532-1538.
[12] Altieri PI, Figueroa Y, Banchs HL, et al. Higher incidence of atrial fibrillation in the metabolic syndrome: a hispanic population study[J]. Bol Asoc Med P R, 2011, 103(4):24-27.
[13] Hung CL, Chao TF, Lai YH, et al. The relationship among atrium electromechanical interval, insulin resistance, and metabolic syndrome[J]. Can J Cardiol, 2013, 29(10):1263-1268.
[14] Huxley RR, Misialek JR, Agarwal SK, et al. Physical activity, obesity, weight change and risk of atrial fibrillation: The atherosclerosis risk in communities (ARIC) study[J]. Circ Arrhythm Electrophysiol, 2014,7(4): 620-625. doi: 10.1161/CIRCEP.113.001244. Epub 2014 Jun 6.
[15] Frost L, Hune LJ, Vestergaard P. Overweight and obesity as risk factors for atrial fibrillation or flutter: the danish diet, cancer, and health study[J]. Am J Med, 2005, 118(5):489-495.
[16] Tsang TS, Barnes ME, Miyasaka Y, et al. Obesity as a risk factor for the progression of paroxysmal to permanent atrial fibrillation: a longitudinal cohort study of 21 years[J]. Eur Heart J, 2008, 29(18): 2227-2233.
[17] Abel ED, Litwin SE, Sweeney G. Cardiac remodeling in obesity[J]. Physiol Rev, 2008, 88(2):389-419.
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