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|本期目录/Table of Contents|

左心耳封堵策略选择

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第1期
页码:
4-006
栏目:
房颤血栓管理-左心耳封堵术
出版日期:
2016-10-05

文章信息/Info

Title:
Left atrial appendage occlusion as a therapeutic strategy for atrial fibrillation
作者:
郭雪原; 马长生
（首都医科大学附属北京安贞医院心内科，北京 100029）
Author(s):
GUO Xue-yuan;  MA Chang-sheng
(Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China)
关键词:
左心耳封堵术; 房颤; 治疗策略
Keywords:
left atrial appendage occlusion;  atrial fibrillation;  therapeutic strategy
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
心房颤动是临床上最常见的心律失常之一，血栓栓塞并发症是其致残、致死的主要原因。经食管超声检查发现，非瓣膜性房颤患者心房内血栓90%位于左心耳。因此，预防左心耳血栓形成可能会减少血栓栓塞事件的发生。口服抗凝药是预防房颤血栓栓塞并发症的有效方法，但是很多患者不能耐受口服抗凝药药物治疗。随着心血管介入治疗和器械研发的进展，经皮左心耳封堵预防卒中越来越受到关注，已经成为一种替代华法林预防房颤并发卒中的有效方法。
Abstract:
Atrial fibrillation (AF) is one of the most common arrthymias. AF places patients at increased risk of thromboembolism, in particular ischemic stroke. The left atrial appendage (LAA) is a site of major blood stasis during AF, increasing the risk of thrombus formation and stroke; 90% of thrombus formation in nonvalvular AF is in the LAA. Therefore, percutaneous LAA exclusion is an evolving treatment to prevent embolic events in patients with nonvalvular AF. Oral anticoagulation (OAC) has been shown to significantly reduce the risk of thromboembolism in numerous studies. Traditional OAC, such as warfarin, has many limitations including constant monitoring, slow onset and offset of action, inter-individual variability in anticoagulant effect, narrow therapeutic index, and food and drug interactions. Therefore, closure of the LAA might provide an alternative strategy to chronic warfarin therapy for stroke prophylaxis in patients with non-valvular atrial fibrillation.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2016-05-31.
通讯作者：马长生，主任医师，主要从事心律失常研究 Email:chshma@vip.sina.com
作者简介：郭雪原，博士 Email:qzguoxy@126.com
更新日期/Last Update: 2016-10-09