射频消融治疗心房颤动前后肺静脉形态结构的变化  

Pulmonary vein morphology in atrial fibrillation patients before and after radiofrequency ablation

作　　者：林明宽 梁柳丹 刘浩[2] 唐梅艳[2] 赵秋燕[2] 周祥群 杨大英 杜永才 

机构地区：[1]海南农垦三亚医院心内科,三亚572000 [2]广西医科大学第一附属医院心内科

出　　处：《介入放射学杂志》2014年第4期288-291,共4页Journal of Interventional Radiology

基　　金：广西自然科学基金资助项目(桂科青0542056);广西医疗卫生重点科研课题(桂卫重200923)

摘　　要：目的：利用CT三维成像技术研究心房颤动（房颤）患者行环肺静脉电隔离术前后肺静脉形态学的变化。方法2008年5月至-2011年7月对24例房颤患者行房颤环肺静脉电隔离术，用64排螺旋CT行心脏扫描。研究随访射频消融（RFA）术后3～6个月患者肺静脉的形态改变特点，并与术前进行对比。结果与术前相比，术后左上肺静脉口最大径、右下肺静脉口最小径、左上肺静脉口截面积差异无统计学意义（P＆gt;0.05），但其他肺静脉口参数最大径、最小径和截面积差异有统计学意义（P＆lt;0.05）。与术前相比，术后右下肺静脉圆度差异有统计学意义（P＆lt;0.05），而其他肺静脉口参数、肺静脉指数及圆度差异无统计学意义（P＆gt;0.05）。男女性别间肺静脉口参数差异无统计学意义（P＆gt;0.05）。24例患者中，右肺静脉开口3支变异达21%，左肺静脉开口3支变异达4%，右肺静脉多支变异达4%。结论房颤患者的肺静脉和左心房一样具有解剖重构，RFA后可逆转其重构。肺静脉开口变异中，右肺静脉开口变异较大。Objective To study the morphological changes of pulmonary vein after circumferential pulmonary vein ablation （CPVA） for atrial fibrillation （AF） by using CT three-dimensional imaging technique. Methods During the period form May 2008 to July 2011 at authors’ hospital, CPVA was carried out in 24 patients with AF. 64-slice spiral CT scanning of the heart was performed. The changes of pulmonary vein morphology 3 - 6 months after CPVA were evaluated and were compared with the preoperative morphologic findings. Results After the treatment, the maximum diameter of the left upper pulmonary vein, the minimum diameter of the right lower pulmonary vein and the cross-section area of the left upper pulmonary vein showed no statistically significant changes when compared with those determined before CPVA （P ＆gt;0.05）. But statistically significant differences in the maximum diameter, the minimum diameter and the cross-section area of the other pulmonary veins existed between the preoperative data and postoperative ones （P ＆lt;0.05）. The roundness of the pulmonary vein mouth determined after CPVA was significantly different from the preoperative one （P＆lt;0.05）. The differences in pulmonary vein mouth parameters, pulmonary vein index and the roundness of pulmonary vein mouth between preoperative and postoperative data were not significant （P ＆gt;0.05）. No significant difference in pulmonary vein mouth parameters existed between male and female patients （P ＆gt; 0.05）. Of the 24 patients, three branches variation of the right pulmonary vein was up to 21%, while three branches variation of the left pulmonary vein was 4%. Conclusion In patients with AF the pulmonary vein, being the same as the left atrium, has also anatomic reconstruction, which can be reversed after CPVA. In the variations of pulmonary vein mouth the variations of right pulmonary vein mouth is most commonly seen.（J Intervent Radiol, 2014, 23：288-291）.

关 键 词：心房颤动 肺静脉 射频消融术 影像学 

分 类 号：R541.75[医药卫生—心血管疾病]