年龄对非瓣膜病心房颤动患者左心房血栓的影响  

Impact of age on the left atrial thrombus in patients with non-valvular atrial fibrillation

作　　者：汤日波[1] 刘畅[1] 马长生[1] 董建增[1] 刘小慧[1] 刘兴鹏[1] 龙德勇[1] 喻荣辉[1] 吴佳慧[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029

出　　处：《中华老年心脑血管病杂志》2010年第3期212-214,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(30900628)

摘　　要：目的评价年龄对非瓣膜病心房颤动(房颤)患者左心房血栓的影响。方法选择拟行导管射频消融完成经食管超声检查的房颤患者421例,根据年龄分为老年组(108例)和年轻组(313例)。根据是否存在左心房血栓又分为血栓组(26例)和无血栓组(395例)。各组间进行一般临床资料比较。结果老年组年龄、高血压、服用血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)的比例明显高于年轻组,非阵发性房颤的比例明显低于年轻组。老年组LVEF明显高于年轻组。血栓组非阵发性房颤、心力衰竭、栓塞史、服用ACEI/ARB的比例明显高于无血栓组。血栓组左心房直径明显大于无血栓组,LVEF明显低于无血栓组。logistic多因素分析显示,校正LVEF、心力衰竭、高血压、糖尿病、服用ACEI/ARB,左心房直径、非阵发性房颤、既往栓塞史是左心房血栓独立预测因素,老年不是左心房血栓独立危险因素。结论年龄不是非瓣膜病房颤患者心房血栓的预测因素。Objective To investigate the impact of age on left atrial thrombus in patients with nonvalvular atrial fibrillation（AF）. Methods Four hundred and twenty-one consecutive patients with AF who planned to undergo transesophageal echoeardiography prior to AF ablation were included. The patients were divided into the elderly group （n = 108） and the young group （n = 313）. The patients were also divided into the thrombus group （n = 26） and the non-thrombus group （n = 395）. Results The proportions of males,hypertension,ACEI/ARB medication were significantly higher in the elderly group. The proportion of non-paroxysmal AF was lower in the elderly group than in the young group. The left ventricular ejection fraction was significantly higher in the elderly group. The proportions of non-paroxysmal AF, heart failure, thromboembolic events, ACEI/ARB medication were significantly higher in the patients with left atrial thrombus （P 0.05, P 〈 0.01）. The left atrium size was larger, the left ventricular ejection fraction was lower in the thrombus group than in the non-thrombus group （P 〈 0.01）. After adjustment for ejection fraction, heart failure, hypertension, diabetes mellituv and ACEI/ARB medication in logistic multivariate analysis,left atrium diameter, non-paroxysmal AF, prior thromboembolic history were independent risk factors for left atrium thrombus. However,age was not an independent risk factor for left atrial thrombus. Conclusions Age itself was not a risk factor for left atrial thrombus in patients with non-valvular AF.

关 键 词：心房颤动 血栓形成 危险因素 年龄因素 

分 类 号：R541.75[医药卫生—心血管疾病] R654.2[医药卫生—内科学]