极速CT对房颤患者的左心房、左心耳、左心室的结构分析及功能评价  

Structural and functional analysis of iCT for left atrium,left atrial appendage and left ventricle in patients with atrial fibrillation

作　　者：张亚博[1] 王灵灵 范惠珍 党晋晋 徐蒙蒙 张兴雨[1] ZHANG Ya-bo;WANG Ling-ling;FAN Hui-zhen;DANG Jin-jin;XU Meng-meng;ZHANG Xing-yu(CT Room of Zhengzhou Seventh People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第七人民医院CT室,河南郑州450000

出　　处：《中国临床研究》2020年第3期333-337,共5页Chinese Journal of Clinical Research

摘　　要：目的应用飞利浦iCT测量评价心房纤颤(房颤)患者的左心房(LA)、左心耳(LAA)、左心室(LV)的功能及结构的变化,分析各个结构与房颤之间的关系,为临床提供有利的影像资料。方法回顾性分析2018年8月至2018年10月经临床确诊为房颤的患者20例(AF组)及20例行冠脉CTA检查阴性的患者(对照组)的临床iCT影像资料,利用后处理工作站分别测量两组样本的左心房最大容积(LAVmax)、左心房最小容积(LAVmin)、左心耳的最大容积(LAAVmax)、左心耳的最小容积(LAAVmin)、左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)、左心室心肌质量(LVMass),并分别计算左心房射血分数(LAEF)、左心耳的射血分数(LAAEF)及左心室的射血分数(LVEF)。根据左心耳有无血栓或血栓前状态将AF组分为血栓阳性AF亚组及血栓阴性AF亚组;根据临床诊断将AF组分为持续性AF亚组及阵发性AF亚组。然后将左心房、左心耳及左心室结构数据及功能数据进行相关统计学分析。结果 AF组LAVmax、LAVmin、LAAVmax、LAAVmin、LVESV、LVMass均高于对照组(P<0.05);AF组LAEF、LAAEF、LVEF均低于正常组(P<0.05)。持续性AF亚组LAVmax、LAVmin、LAAVmax、LAAVmin、LVESV、LVMass均高于阵发性AF亚组(P<0.05),LAEF、LAAEF、LVEF均低于阵发性AF亚组(P<0.05),LVEDV与阵发性AF亚组差异无统计学意义(P>0.05)。血栓阳性AF亚组LAVmax、LAVmin、LAAVmax、LAAVmin均高于血栓阴性AF亚组(P<0.05),LAEF、LAAEF、LVEF均低于血栓阴性AF亚组(P<0.05),LVEDV、LVESV、LVMass与血栓阴性AF亚组差异无统计学意义(P>0.05)。结论 AF患者左心房、左心耳及左心室结构、功能重构,持续性房颤较阵发性房颤更加明显,左心耳血栓阳性的房颤患者较左心耳血栓阴性的患者更加明显。Objective To evaluate the functional and structural changes of left atrium(LA),left atrial appendage(LAA) and left ventricle(LV) in patients with atrial fibrillation(AF) by using Philips Brilliance iCT to analyze the relationship between each structure and AF and to provide favorable imaging data for clinic.Method A retrospective analysis was performed for the clinical iCT images of 20 patients with confirmed AF(AF group) and 20 patients(control group) with negative computed tomographic angiography(CTA) from August 2018 to October 2018.Using the post-processing workstation software,the left atrial maximum volume(LAVmax),left atrial minimum volume(LAVmin),left atrial appendage maximum volume(LAAVmax),left atrial appendage minimum volume(LAAVmin),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV) and left ventricular myocardium mass(LVMass) were measured respectively in two groups.and the left atrial ejection fraction(LAEF),left atrial appendage fraction(LAAEF),and left ventricular ejection fraction(LVEF) were calculated.According to whether there was thrombus or prethrombotic state in left atrial appendage,AF group was divided into positive AF subgroup and negative AF subgroup;according to clinical diagnosis,AF group was divided into persistent AF subgroup and paroxysmal AF subgroup.Correlation statistical analysis was made on the structural and functional data of left atrium,left auricle and left ventricle.Results LAVmax,LAVmin,LAAVmax,LAAVmin,LVESV and LVMass in AF group were significantly higher than those in control group,and LAEF,LAAEF,LVEF were lower than those in control group(all P<0.05).LAVmax,LAVmin,LAAVmax,LAAVmin,LVESV and LVMass in persistent AF subgroup were significantly higher than those in paroxysmal AF subgroup,and LAEF,LAAEF,LVEF were significantly lower than those in paroxysmal AF subgroup(all P<0.05),however,there was no statistical difference in LVEDV between two subgroups(P>0.05).LAVmax,LAVmin,LAAVmax and LAAVmin in thrombotic-positive AF subgroup were h

关 键 词：心房纤颤 左心房 左心耳 左心室 容积 射血分数 X线电子计算机断层扫描 极速CT 

分 类 号：R541.7+5[医药卫生—心血管疾病]