非瓣膜性房颤患者的左心耳特征分析  

Characteristics of left atrial appendage in patients with non-valvular atrial fibrillation

作　　者：刘桂剑 李亚娜 陈瑞珍 朱文青[1,2] 葛均波 LIU Gui-jian;LI Ya-na;CHEN Rui-zhen;ZHU Wen-qing;GE Jun-bo(Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China;Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine,Shanghai 200127, China)

机构地区：[1]复旦大学附属中山医院心内科,上海200032 [2]上海市心血管病研究所,上海200032 [3]上海交通大学医学院附属仁济医院心内科,上海200127

出　　处：《中国临床医学》2020年第3期453-456,共4页Chinese Journal of Clinical Medicine

基　　金：上海市青年科技英才扬帆计划(19YF1427900);上海市科学技术委员会项目(17DZ1930102).

摘　　要：目的:探讨非瓣膜性房颤患者左心耳特征。方法:收集2019年1月1日至2019年12月31日复旦大学附属中山医院心内科收治的237例非瓣膜性房颤患者病例资料。回顾性分析阵发性房颤组(106例)与持续性房颤组(131例)左心耳入口内径、长度及左心耳射血速率的差异,并分析房颤患者左心耳入口内径、长度及射血速率的临床相关因素。结果:与阵发性房颤组相比,持续性房颤组左心耳入口内径显著增大,差异具有统计学意义(P<0.05),而2组患者的左心耳长度及左心耳射血速率无统计学差异。左心耳入口内径与身高、房颤病史长短、左房前后径、左室收缩末内径(left ventricular end-systolic diameter,LVESD)、左室舒张末内径(left ventricular end-diastolic diameter,LVEDD)正相关(P<0.05),与左室射血分数(left ventricular ejection fraction,LVEF)负相关(P<0.05);左心耳长度与左房前后径、LVESD、LVEDD正相关(P<0.05),与LVEF负相关(P<0.05);左心耳射血速率与年龄、房颤病史长短、左房前后径、LVESD负相关(P<0.05),与LVEF正相关(P<0.05)。结论:持续性房颤患者左心耳入口内径大于阵发性房颤患者,左心耳的入口内径、长度、射血速率与身高、房颤病史长短、左房前后径等多种因素相关。Objective:To explore the characteristics of left atrial appendage(LAA)in patients with non-valvular atrial fibrillation(AF).Methods:From January 1,2019 to December 31,2019,237 patients of non valvular atrial fibrillation AF were collected from Zhongshan Hospital,Fudan University.The differences of internal diameter and length of LAA orifice and LAA ejection rate between paroxysmal AF(n=106)and persistent AF(n=131)were analyzed retrospectively.The clinical related factors of internal diameter,length and ejection rate of LAA orifice in patients with AF were analyzed.Results:Diameter of LAA orifice was significantly larger in persistent AF group than paroxysmal AF group(P<0.05).There was no significant difference in LAA length and LAA ejection rate between the two groups.Spearman correlation coefficient analysis showed that diameter of LAA orifice was positively correlated with body height,duration of AF,left atrial diameter,left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),and was negatively correlated with left ventricular ejection fraction(LVEF),(P<0.05).Length of LAA was positively correlated with left atrial diameter,LVESD,LVEDD and was negatively correlated with LVEF(P<0.05);LAA ejection velocity was negatively correlated with age,duration of AF,left atrial diameter,LVESD,and positively correlated with LVEF(P<0.05).Conclusions:Compared with paroxysmal AF patients,persistent AF patients had larger LAA ostium.The diameter of LAA orifice,LAA length and ejection velocity are correlated with height,history of AF,left atrium diameter and so on.

关 键 词：非瓣膜性房颤 阵发性房颤 持续性房颤 左心耳 

分 类 号：R541[医药卫生—心血管疾病]