心电图和超声心动图检测非瓣膜性心房颤动患者左心房血栓临床观察  

Clinical observation of electrocardiogram and echocardiography for the detection of left atrial thrombi in patients with non-valvular atrial fibrillation

作　　者：余淑华[1] 刘晓宇[2] 

机构地区：[1]郑州大学附属郑州中心医院老年心内科,河南郑州450007 [2]河南省人民医院急诊医学部,河南郑州450003

出　　处：《新乡医学院学报》2015年第6期563-565,共3页Journal of Xinxiang Medical University

摘　　要：目的通过对非瓣膜性心房颤动(NVAF)患者进行经食管超声心动图(TEE)检测左心房和(或)左心耳血栓,并结合心电图f波特点及经胸超声心动图指标,从而筛选出血栓栓塞的高危患者,为临床进行抗凝治疗提供依据。方法 84例NVAF患者均行TEE检查,根据检查时有无血栓及有无血栓前状态分为血栓阳性组(13例)、血栓前状态阳性组(15例)和血栓阴性组(56例)。所有患者均描记心电图V1长导联,顺序测量20个f波振幅,然后取其平均值作为受检者f波振幅值;所有患者同时行TEE测定左心房内径(LAD)、左心室舒张末期内径(LVEDD)及左心室射血分数(LVEF)。对上述各参数进行分析对比,探讨其相互关系。结果血栓阳性组和血栓前状态阳性组患者细颤发生率分别为84.6%、66.7%,均高于血栓阴性组的57.1%,但3组比较差异均无统计学意义(P>0.05)。血栓阳性组、血栓前状态阳性组、血栓阴性组患者f波振幅分别为(0.058±0.038)、(0.089±0.043)、(0.097±0.039)m V。血栓阳性组患者f波振幅显著低于血栓阴性组(P<0.05);血栓前状态阳性组患者f波振幅略低于血栓阴性组,血栓阳性组患者f波振幅低于血栓前状态阳性组,但差异均无统计学意义(P>0.05)。血栓阳性组和血栓前状态阳性组患者LAD高于血栓阴性组(P<0.05),血栓阳性组LAD稍高于血栓前状态阳性组(P>0.05);3组患者LVEDD和LVEF比较差异均无统计学意义(P>0.05)。结论检测f波振幅有助于血栓栓塞风险性预测,经胸超声心动图指标中LAD对预测血栓栓塞风险性有一定价值。Objective To screen thromboembolism high-risk patients and provide evidence for anticoagulant therapy according to the transesophageal echocardiography（ TEE） inspection of left atrium and（ or） left atrial appendage thrombi to non-valvular atrial fibrillation（ NVAF） patients,the features of electrocardiographic（ ECG） f-wave and transthoracic echocardiography index. Methods A total of 84 NAVF patients examined with TEE were divided into thrombus group（13 cases）,prothrombotic-state group（15 cases） and non-thrombus group（56 cases） according to the results of TEE. The ECG in V1 long leads of all patients was recorded. And proceeding measurements of twenty f-waves amplitudes were averaged as subjects＇ fwaves amplitudes. Meanwhile,left atrium diameter（ LAD）,left ventricular end-diastolic diameter（ LVEDD） and left ventricular ejection fraction（ LVEF） of all patients were examined with TEE. Then all parameters were analyzed and compared to explore their relations. Results The incidence rate of fine atrial fibrillation in thrombus group was 84. 6% and in prothrombitic-state group it was 66. 7%,both higher than 57. 1% of non-thrombus group,but above comparison had no significant difference among these three groups（ P〈0. 05）. Amplitudes of f-wave in thrombus,prothrombotic-state and non-thrombus groups were respectively（0. 058 ± 0. 038）,（0. 089 ± 0. 043） and（0. 097 ± 0. 039） m V. The amplitude of f-wave in thrombus group was significantly lower than that in non-thrombus group（ P〈0. 05）; The amplitude of f-wave in prothrombotic-state group was slightly lower than that in non-thrombus group and thrombus group was lower than prothrombotic-state group,but neither of them had significant difference（ P〈0. 05）. LAD in thrombus group and prothrombotic-state group was higher than that in nonthrombus group（ P〉0. 05）;LAD in thrombus group was slightly higher than that in the prothrombotic-state group（ P〈0. 05）;and for LVEDD and LVEF,there was no signi

关 键 词：非瓣膜性心房颤动 经食管超声心动图 左心房内径 血栓栓塞 

分 类 号：R455.1[医药卫生—运动医学]