心房颤动环肺静脉消融术后复发患者肺静脉、左心房容积CT成像研究  

CT imaging study of pulmonary vein and left atrial volume in patients with recurrence of atrial fibrillation after circumferential pulmonary vein ablation

作　　者：林明宽 张明哲 张华 梁柳丹 刘浩[2] 吉晓理 晏君 汪英男 LIN Mingkuan;ZHANG Mingzhe;ZHANG Hua;LIANG Liudan;LIU Hao;Jl Xiaoli;YAN Jun;WANG Yingnan(Department of Cardiology,Scmya Municipal People＇s Hospital,Sanya,Hainan Province 572001,China)

机构地区：[1]三亚市人民医院心内科,海南572001 [2]广西医科大学第二附属医院心内科 [3]内蒙古乌兰察布市中心医院老年病科

出　　处：《介入放射学杂志》2018年第10期924-927,共4页Journal of Interventional Radiology

基　　金：广西医疗卫生重点科研课题项目(桂卫重200923);内蒙古自然科学基金面上项目(2016MS0844)

摘　　要：目的采用CT三维成像技术观察心房颤动(AF)环肺静脉消融(CPVA)术后复发患者肺静脉(PV)形态和左心房容积(LAV)变化。方法对60例AF患者行CPVA术,随访3～6个月。根据术后AF有无复发,分为未复发组(n=32)和复发组(n=28)。采用Light Speed 64排螺旋CT测量CPVA术前后PV口直径、截面积和LAV,并进行对比分析。结果两组患者年龄、性别及随访时间、手术时间差异均无统计学意义(P>0.05)。复发组平均随访(5.2±0.8)个月,早期复发20例(71.4%),晚期复发8例(28.6%)。未复发组手术前后右上PV口最大径(RSPVdmax)、最小径(RSPVdmin),右下PV口最大径(RIPVdmax)、最小径(RIPVdmin),左上PV口最大径(LSPVdmax),4个PV口截面积(CSA)及LAV差异均有统计学意义(P<0.05);左下PV口最大径(LIPVdmax)、最小径(LIPVdmin),左上PV口最小径(LSPVdmin)差异均无统计学意义(P>0.05)。复发组术后仅见RIPVdmax、RIPVCSA、LIPVCSA较术前减少(P<0.05),其它PV指标和LAV差异均无统计学意义(P>0.05)。结论 AF患者CPVA术后早期复发率高,复发组患者PV、LAV无明显增大。Objective Using CT three-dimensional imaging technique to observe the morphological changes of pulmonary vein （PV） and left atrium volume （LAV） in patients with recurrence of atrial fibrillation （AF） after receiving circumferential pulmonary vein ablation （CPVA）. Methods A total of 60 AF patients underwent CP~＇A, and all the patients were followed-up for 3-6 months. According to the recurrence of AF or not after CPVA, the patients were divided into non-recurrence group （rr=32） and recurrence group （n=28）. Light Speed 64-row spiral CT scanning was used to measure both the preoperative and the postoperative PV diameter, cross-sectional area （CSA） of PV, and LAV, the results were analyzed and compared between the two groups. Results No statistically significant differences in age, sex, follow-up time and time spent for ablation procedure existed between the two groups （P〉0.05）. In the recurrence group, the mean follow-up time was （5.2±0.8） months, early recurrence of AF was observed in 20 patients （71.4%）, and the late recurrence of AF was seen in 8 patients （28.6%）. In the non-recurrence group, the postoperative maximum diameter of right superior PV （RSPVdmax）, minimum diameter of right superior PV （RSPVdmin）, maximum diameter of right inferior PV （RIPVdmax）, minimum diameter of right inferior PV （RIPVdmin）, maximum diameter of left superior PV （LSPVdmax）, CSAs of four PVs, and LAV were significantly different from the preoperative data （P〈0.05）, while the postoperative maximum diameter of left inferior PV （LIPVdmax）, minimum diameter of left inferior PV （LIPVdmin） and minimum diameter of left superior PV （ISPVdmin） were not significantly different from the preoperative data （P 〉0.05）. In the recurrence group, only postoperative RIPVdmax, RIPVCSA and LIPVCSA values were decreased significantly after CPVA （P〈0.05）, and no statistically significant differences in other PV indexes and LAV existed between preoperative val

关 键 词：CT 心房颤动 肺静脉 左心房容积 环肺静脉消融 复发 

分 类 号：R541.75[医药卫生—心血管疾病]