阵发性心房颤动患者左心耳血栓形成的相关因素  

Related factors of left atrial appendage thrombus formation in patients with paroxysmal atrial fibrillation

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 Xiao-fei;LIU Nan-nan;HAN Ya-ling;ZHOU Wei-wei;LIANG Ming;WANG Zu-lu(Department of Cardiology, General Hospital of Shenyang Military Command of PLA, Shenyang 110015, Liaoning, China)

机构地区：[1]沈阳军区总医院心内科,辽宁沈阳110015

出　　处：《心脏杂志》2018年第4期423-425,共3页Chinese Heart Journal

基　　金：辽宁省科学技术计划项目资助(2015020443)

摘　　要：目的应用经胸和经食管超声探讨阵发性心房颤动(paroxysmal atrial fibrillation,PAF)患者左心耳血栓形成的相关因素。方法 PAF患者212例,以左心耳内有无血栓将患者分为血栓组(44例)和无血栓组(168例),详细记录两组患者的一般资料,经胸超声(TTE)参数:左房内径(LAD)、左房舒张末期容积(LAEDV)、左房收缩末期容积(LAESV)、左房射血分数(LAEF),经食管超声(TEE)参数:左心耳内血流速度(LAA-v)、45°,90°,135°切面左心耳横径(LAA-W)、左心耳深度(LAA-D)。比较两组患者的各项指标差别并进行多因素Logistic回归分析。结果两组患者中性别、年龄、并发高血压病、糖尿病、高脂血症、LAA-W及LAA-D差异均无统计学意义;患者的冠心病比例、LAD、LAEDV和LAESV血栓组大于无血栓组,LAEF及LAA-v血栓组小于无血栓组,差异均有统计学意义(均P<0.05);多因素Logistic回归分析显示,LAEF(OR=1.163,95%CI:1.043~1.296,P<0.01)及LAA-v(OR=29.82,95%CI:7.97~29.82,P<0.05)是血栓形成的独立危险因素。结论 PAF患者左心耳内血栓形成与LAEF及LAA-v密切相关。AIM To investigete related factors of left atrial appendage （LAA） thrombus formation in patients with paroxysmal atrial fibrillation by transesophageal echocardiography （TEE） and transthoracic echocardiography （TTE）. METHODS 212 patients with paroxysmal atrial fibrillation undergoing TEE were selected, and all patients were divided into LAA thrombus group （n=44） and non LAA thrombus group （n=168）. General information, TTE parameters： LAD, LAEDV, LAESV, LAEF and TEE parameters： LAA-v, LAA width （LAA-W） and LAA depth （LAA-D） at 45°90°135°in detail, and Binary Logistic Regression Analysis was used to explore related factors. RESULTS No significant differences were found between the two groups at age, sex, proportion of hypertention, diabetes and hyperlipidemia, and LAA-W, LAA-D at 45°90°135°. The proportion of coronary heart disease, LAD, LAEDV and LAESV were higher, but LAEF and LAA-v were lower in the thrombus group （P〈0.05）. Binary Logistic Regression Analysis demonstrated that LAEF （OR=1.163, 95%CI： 1.043-1.296, P〈0.01） and LAA-v （OR=29.82, 95%CI： 7.97-29.82, P〈0.05） were independent risk factors. CONCLUSION Thrombosis of left atrial appendages in patients with paroxysmal atrial fibrillation are closely related to LAEF and LAA-v.

关 键 词：心房颤动 经食管超声 左心耳血栓 左房射血分数 

分 类 号：R541.7[医药卫生—心血管疾病]