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|本期目录/Table of Contents|

阵发性心房颤动患者左心耳血栓形成的相关因素

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2018年第4期
页码:
423-425
栏目:
临床研究
出版日期:
2018-04-25

文章信息/Info

Title:
Related factors of left atrial appendage thrombus formation in patients with paroxysmal atrial fibrillation
作者:
邢小飞刘楠楠韩雅玲周微微梁 明王祖禄
(沈阳军区总医院心内科,辽宁 沈阳 110015)
Author(s):
XING Xiao-fei LIU Nan-nan HAN Ya-ling ZHOU Wei-wei LIANG Ming WANG Zu-lu
(Department of Cardiology, General Hospital of Shenyang Military Command of PLA, Shenyang 110015, Liaoning, China)
关键词:
心房颤动经食管超声左心耳血栓左房射血分数
Keywords:
atrial fibrillation left atrial appendage thrombus transesophageal echocardiography left atrial ejection fraction
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的 应用经胸和经食管超声探讨阵发性心房颤动(paroxysmal atrial fibrillation,PAF)患者左心耳血栓形成的相关因素。方法 PAF患者212例,以左心耳内有无血栓将患者分为血栓组(44例)和无血栓组(168例),详细记录两组患者的一般资料,经胸超声(TTE)参数:左房内径(LAD)、左房舒张末期容积(LAEDV)、左房收缩末期容积(LAESV)、左房射血分数(LAEF),经食管超声(TEE)参数:左心耳内血流速度(LAA-v)、 45°,90°,135°切面左心耳横径(LAA-W)、左心耳深度(LAA-D)。比较两组患者的各项指标差别并进行多因素Logistic回归分析。结果 两组患者中性别、年龄、并发高血压病、糖尿病、高脂血症、 LAA-W及LAA-D差异均无统计学意义;患者的冠心病比例、LAD、LAEDV和LAESV血栓组大于无血栓组,LAEF及LAA-v血栓组小于无血栓组,差异均有统计学意义(均P<0.05);多因素Logistic回归分析显示,LAEF(OR=1.163, 95%CI:1.043~1.296,P<0.01)及LAA-v(OR=29.82,95%CI:7.97~29.82,P<0.05)是血栓形成的独立危险因素。结论 PAF患者左心耳内血栓形成与LAEF及LAA-v密切相关。
Abstract:
AIM To investigete related factors of left atrial appendage (LAA) thrombus formation in patients with paroxysmal atrial fibrillation by transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE). METHODS 212 patients with paroxysmal atrial fibrillation undergoing TEE were selected, and all patients were divided into LAA thrombus group (n=44) and non LAA thrombus group (n=168). General information, TTE parameters: LAD, LAEDV, LAESV, LAEF and TEE parameters: LAA-v, LAA width (LAA-W) and LAA depth (LAA-D) at 45°90°135°in detail, and Binary Logistic Regression Analysis was used to explore related factors. RESULTS No significant differences were found between the two groups at age, sex, proportion of hypertention, diabetes and hyperlipidemia, and LAA-W, LAA-D at 45°90°135°. The proportion of coronary heart disease, LAD, LAEDV and LAESV were higher, but LAEF and LAA-v were lower in the thrombus group (P<0.05). Binary Logistic Regression Analysis demonstrated that LAEF (OR=1.163, 95%CI: 1.043-1.296, P<0.01) and LAA-v (OR=29.82, 95%CI: 7.97-29.82, P<0.05) were independent risk factors. CONCLUSION Thrombosis of left atrial appendages in patients with paroxysmal atrial fibrillation are closely related to LAEF and LAA-v.

参考文献/References

[1]Chugh SS,Havmoeller R,Narayanan K,et al.Worldwide epidemiology of atrial fibrillation a global burden of disease 2010 study[J].Circulation,2014,129(8):837-847.

[2]Wasilewska M,Gosk-Bierska I.Thromboembolism associated with atrial fibrillation as a cause of limb and organ ischemia[J].Adv Clin Exp Med,2013,22(6):865-873.

[3]Matsumoto Y,Morino Y,Kumagai A,et al.Characteristics of Anatomy and Function of the Left Atrial Appendage and Their Relationships in Patients with Cardioembolic Stroke:A 3-Dimensional Transesophageal Echocardiography Study[J].J Stroke Cerebrovasc Dis,2017,26(3):470-479.

[4]Kobza R,Schoenenberger AW,Cuculi F,et al.Impact of cardiac computed tomography of the interatrial septum before pulmonary vein isolation[J].Pacing Clin Eleetrophysiol,2013,36(10):1245-1250.

[5]相晓军,贾玉和,李学文,等.阵发性心房颤动持续时间与血栓性疾病的临床观察[J].中华心律失常学杂志,2017,21(1):67-69.

[6]You JJ,Singer DE,Howard PA,et al.Antithrombotic therapy for atrial fibrillation:Antithrombotic Therapy and Prevention of Thrombosis,9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J].Chest,2012,141(2 Suppl):e531S-e575S.

[7]Lee JM,Shim J,Uhm JS,et al.Impact of increased orifice size and decreased flow velocity of left atrial appendage on stroke in nonvalvular atrial fibrillation[J].Am J Cardiol,2014,113(6):963-969.

[8]Faustino A,Providencia R,Barra S,et al.Which method of left atrium size quantification is the most accurate to recognize thromboembolic risk in patients with non-valvular atrial fibrillation[J].Cardiovasc Ultrasound,2014,12(1):28.

[9]Scherr D,Dalal D,Chilukuri K,et al.Incidence and predictors of left atrial thrombus prior to catheter ablation of atrial fibrillation[J].J Cardiovasc Electrophysiol,2009,20(4):379-384.

备注/Memo

备注/Memo:
收稿日期:2017-07-29.基金项目:辽宁省科学技术计划项目资助(2015020443) 通讯作者:刘楠楠,副主任医师,主要从事心血管疾病超声诊断研究 Email:nuomigao@gmail.com 作者简介:邢小飞,硕士生 Email:15998188639@163.com
更新日期/Last Update: 1900-01-01