经食管超声评价达比加群酯治疗左心耳血栓疗效相关影响因素  

Evaluation of the Factors of Dabigatran Etexilate on the Treatment of Left Atrial Appending Thrombus by Transesophageal Echocardiography

作　　者：邢小飞[1] 刘楠楠[1] 韩雅玲[1] 周微微[1] 梁明[1] 王祖禄[1] Xing Xiaofei;Liu Nannan;Han Yaling;Zhou Weiwei;Liang Ming;Wang Zulu(Department of Cardiology, General Hospital of Shenyang Military Command of PLA, Shenyang, Liaoning 110015, China)

机构地区：[1]沈阳军区总医院心内科,沈阳市110015

出　　处：《中国超声医学杂志》2018年第2期125-128,共4页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省科学技术计划项目(No.2015020443)

摘　　要：目的应用经胸及经食管超声评价达比加群酯治疗左心耳血栓疗效相关影响因素。方法收集房颤并左心耳血栓患者,达比加群酯抗凝治疗随访(10±0.6)周后复查心脏超声,与治疗前相比判断血栓消融情况并测量左房内径(LAd)、左房射血分数(LAEF)、左室射血分数(LVEF)及左心耳内血流速度(LAA-v)。据血栓消融情况将患者分为无效组(血栓无明显减小甚至增大)(A组)、部分溶解组(B组)和完全溶解组(C组),并对各测量指标进行统计学分析。结果 58例患者随访(10±0.6)周后,15例患者血栓完全溶解,21例患者血栓减小,22例患者治疗无效;三组间患者的性别、年龄、高血压病和糖尿病比例差异无统计学意义;与A组相比,B组中的持续性房颤比例低于A组,LAEF及LAA-v高于A组,C组中的持续性房颤比例及LAd低于A组,LAEF及LAA-v高于A组(均P<0.05);与B组相比C组中各测值差异无统计学意义。结论达比加群酯抗凝疗效与房颤类型、LAd、LAEF及LAA-v相关。Objective To evaluate the factors of dabigatran etexilate on the treatment of left atrial appending （LAA） thrombus in patients with atrial fibrillation by Transthoraeic eehocardiography （TTE） and Transesophageal echocardiography （TEE）. Methods 58 patients of LAA thrombus with atrial fibrillation in our hospital were enrolled. Cardiac echocardiography was performed to evaluate the ablation of thrombus and measure the left atrial diame ter （LAd）, left atrial ejection fraction （LAEF）, left ventricular ejection fraction （LVEF） and LAA flow velocity （LAA v） after followed up for （10±0.6） weeks. All the patients were divided into invalid group （thrombus did not significantly reduce or even increase）（group A）, partially dissolved group（group B） and completely dissolved group （group C）. And data were calculated and analysized. Results 15 patients of LAA thrombus dissolved completely, 21 patients of LAA thrombus reduced significantly, and 22 patients of LAA tbrombus did not significantly reduce or even increase. There was no significant difference in the gender, age, hypertension and diabetes among the three groups. The persistent atrial fibrillation was significantly lower and the LAEF and LAA-v were significantly higher in group B compared with group A,and in group C the persistent atrial fibrillation and LAd were significantly lower and the LAEF and LAA-v were significantly higher to compare with group A （all P〈0.05）. While all the parameters in group C have no significant difference compared with group B. Conclusions The factors of dabigatran etexilate on the treatment of LAA thrombus in patients with atrial fibrillation was significantly correlated with the type of atrial fibril lation,LAd,LAEF and LAA-v.

关 键 词：心房颤动 左心耳血栓 达比加群酯 抗凝 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.75[医药卫生—诊断学]