多层螺旋CT评价不同类型心房颤动患者左心房和左心耳功能  

Multi-slice spiral CT evaluation on function of left atrium and left atrial appendage in patients with different subtypes of atrial fibrillation

作　　者：卓利勇 李彩英[1] 袁迎芳 田伟伟 杨兰[1] 陈琛 ZHUO Liyong;LI Caiying;YUAN Yingfang;TIAN Weiwei;YANG Lan;CHEN Chen(Department of Medical Imaging, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China)

机构地区：[1]河北医科大学第二医院医学影像科

出　　处：《中国医学影像技术》2019年第8期1205-1209,共5页Chinese Journal of Medical Imaging Technology

基　　金：河北省人力资源和社会保障项目(3101-04-03-02-05-14)

摘　　要：目的采用多层螺旋CT定量测量心房颤动(AF)患者左心房、左心耳功能,探讨不同类型AF患者之间左心房及左心耳功能的差异。方法收集71例AF患者,包括阵发性房颤(PAF)40例(PAF组),持续性房颤(PeAF)31例(PeAF组)。应用心功能后处理软件测量AF患者左心耳最大容积(LAAVmax)、左心耳最小容积(LAAVmin)、左心房最大容积(LAVmax)和左心房最小容积(LAVmin),并计算左心耳射血分数(LAAEF)、左心耳射血量(LAAEV)、左心房射血分数(LAEF)、左心房射血量(LAEV)。结果PeAF组LAAEF、LAEF、LAEV均小于PAF组(P均<0.01),LAAVmax、LAAVmin、LAVmax、LAVmin均大于PAF组(P均<0.05)。2组间LAAEV差异无统计学意义(P=0.23)。AF患者LAAEF与LAEF呈正相关(rs=0.57,P<0.01),与AF持续时间呈负相关(rs=-0.26,P=0.03)。结论应用多层螺旋CT可以客观评价左心房和左心耳功能,对认识不同分型AF患者左心耳和左心房功能改变有重要临床意义。Objective To explore the function of left atrium (LA) and left atrial appendage (LAA) in different subtypes of atrial fibrillation (AF) based on quantitative measurement using multi-slice spiral CT. Methods Totally 71 AF patients were enrolled, including 40 with paroxysmal atrial fibrillation (PAF group) and 31 with persistent atrial fibrillation (PeAF group). The maximum volume of LAA (LAAV max ), the minimum volume of LAA (LAAV min ), the maximum volume of LA (LAV max ) and the minimum volume of LA (LAV min ) were measured using cardiac function post-processing software, and LAA ejection fraction (LAAEF), LAA ejection volume (LAAEV), LA ejection fraction (LAEF) and LA ejection volume (LAEV) were calculated. Results LAAEF, LAEF and LAEV in PeAF group were less than those in PAF group (all P <0.01), while LAAV max , LAAV min , LAV max and LAV min in PeAF group were all larger than those in PAF group (all P <0.05). There was no significant difference of LAAEV between the 2 groups ( P =0.23). LAAEF was positively correlated with LAEF in AF patients ( r s =0.57, P <0.01), and negatively correlated with duration of atrial fibrillation ( r s =-0.26, P =0.03). Conclusion Multi-slice spiral CT can be used to objectively evaluate the function of LA and LAA.It has important clinical significance for understanding the functional changes of LA and LAA in different subtypes of AF.

关 键 词：心房颤动 心耳 心房功能 左 体层摄影术 X线计算机 

分 类 号：R541.75[医药卫生—心血管疾病] R814.42[医药卫生—内科学]