非瓣膜性心房颤动患者左心耳功能与左心耳血栓形成的关系  

The relationship of left atrial appendage function and thrombogenesis in nonvalvular atrial fibrillation patients

作　　者：曾辉 赵超占 吴建军 杨李智 余佳 

机构地区：[1]延安大学咸阳医院超声科,咸阳712000

出　　处：《广西医科大学学报》2017年第11期1585-1587,共3页Journal of Guangxi Medical University

摘　　要：目的:探讨非瓣膜性心房颤动(房颤)患者左心耳功能与左心耳内血栓形成的关系。方法:选取2015年1月至2016年5月延安大学咸阳医院收治的非瓣膜性房颤患者96例作为研究组,根据左心耳血栓情况将其分为血栓组(38例)和无血栓组(58例)。另选取同期在本院行健康体检的23例健康志愿者作为对照组。应用经食管超声心动图(TEE)测定各组左心耳容积及功能参数,并采用多因素Logistic回归分析法分析左心耳血栓形成的影响因素。结果:研究组左心耳舒张末期容积(EDV)、左心耳排空分数(EF)及左心房内径(LAD)显著高于对照组,左心耳最大充盈速度(PDV)、左心耳最大排空速度(PSV)明显低于对照组(均P<0.05)。血栓组EDV、EF和LAD显著高于无血栓组和对照组(P<0.05),PSV和PDV显著低于无血栓组和对照组(P<0.05)。多因素Logistic回归分析显示,EDV、PSV、PDV和EF是非瓣膜性房颤合并血栓形成的独立危险因素(均P<0.05)。结论:非瓣膜性房颤患者左心耳功能减低、血流速度减慢是左心耳血栓形成的重要危险因素,左心耳功能检测有助于及时发现血栓和指导治疗。Objective： To investigate the relationship between left atrial appendage （LAA）function and thrombogenesis in patients with nonvalvular atrial fibrillation （NVAF）. Methods： 96 NVAF patients treated in our hospital from January 2015 to May 2016 were selected and divided into thrombogenesis group （38 cases）and non-throm- bogenesis group （58 cases）. 23 healthy subjects were enrolled as a control group. Left atrial diastolic end volume （EDV）, left atrial end systolic volume （ESV）, left atrial emptying fraction （EF）, left atrial diameter （LAD）, LAA flow emptying velocity （LAA-FEV）, LAA flow filling velocity （LAA-FFV）were measured by transesophageal echocardiography （TEE）. The factors for LAA thrombogenesis were analyzed by multiple logistic regression analysis. Results： Patients with NVAF had significantly higher EDV, EF and LAD, and lower PDV and PSV than the controls （P〈 0. 05）. EDV, EF and LAD were higher, but PSV and PDV were lower in non-thrombosis group than those in thrombosis group and control group （P〈0. 05）. Multiple logistic regression analysis revealed that EDV, PSV, PDV and EF were the risk factors for NVAF complicated with LAA thrombosis （P〈0. 05）. Conclusion： Lower LAA function and blood flow were the risk factors for NVAF complicated with LAA thrombosis. The evaluation of LAA function could help timely discover thrombosis and guide treatment.

关 键 词：非瓣膜性心房颤动 左心耳 血栓 经食管超声心动图 

分 类 号：R541.7[医药卫生—心血管疾病]