超声评价左心耳血栓形成的影响因素  

The Influencing Factors of Thrombus in Left Atrial Appendage Evaluated By Ultrasound

作　　者：陈银凤 刘楠楠 王祖禄 梁明 周微微 Chen Yinfeng;Liu Nannan;Wang Zulu;Liang Ming;Zhou Weiwei(Jinzhou Medical University,Northern Theater Command General Hospital Postgraduate Training Base,Shenyang,Liaoning 110016,China;Cardiovascular Research Institute of Northern Theater Command General Hospital Shenyang,Liaoning 110016,China)

机构地区：[1]锦州医科大学北部战区总医院研究生培养基地,沈阳市110016 [2]北部战区总医院全军心血管病研究所

出　　处：《中国超声医学杂志》2020年第9期799-801,共3页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省自然科学基金计划项目(No.20180550396)。

摘　　要：目的应用超声心动图评价房颤患者左心耳血栓形成的相关因素及其预测价值。方法选取58例非瓣膜性房颤伴左心耳血栓患者为血栓组(A组),另选取60例非瓣膜性房颤不伴左心耳血栓患者为非血栓组(B组),记录患者基线资料。对两组患者进行经胸及经食管超声心动图检查,对比两组患者左房内径(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)、左室射血分数(LVEF)、左心耳口平均横径(LAA-w)及左心耳内血流速度(LAA-v),进行统计学分析。结果A组LAEF、LVEF、LAA-v均小于B组,LAEDV、LAESV、LAd均大于B组(P<0.05)。多因素Logistics回归分析显示LAd>39.5 mm,LAEF<48.5%与左心耳血栓形成相关,且校正了年龄、性别及CHA2DS2-VASc评分后亦如此。结论房颤患者左心耳血栓形成与左房结构及功能改变相关,且有一定预测价值。Objective Ultrasound was used to evaluate the related factors and predictive value of left atrial appendage thrombosis in patients with atrial fibrillation.Methods 58 patients with non valvular atrial fibrillation with left atrial thrombus were selected as the thrombus group(group A),and 60 patients with non valvular atrial fibrillation without left atrial thrombus were selected as the non-thrombus group(group B),the baseline data of the patients were recorded.Transthoracic and transesophageal echocardiography were performed in both groups.and the Left atrial diameter(LAD),left atrial end-diastolic volume(LAEDV),left atrial end-systolic volume(LAESV),left atrial jection fraction(LAEF),left ventricular ejection fraction(LVEF),average width of left atrial appendage(LAA-w),left atrial appendage blood flow velocity(LAA-v)were compared between the two groups,and statistical analysis was made.Results The LAEF,LVEF and LAA-v in group A were lower than those in group B,LAEDV,LAESV and LAd was higher than that in group B(P<0.05).Multivariate logistic regression analysis showed that LAd>39.5 mm,LAEF<48.5%were related to left atrial appendage thrombosis,this was also true after adjusting for age,gender and CHA2 DS2-VASc scores.Conclusions Thrombus formation of left atrial appendage in patients with atrial fibrillation is related to the changes of left atrial structure and function,and has certain forecast value.

关 键 词：超声 心房颤动 左心耳 血栓 

分 类 号：R541.75[医药卫生—心血管疾病] R445.1[医药卫生—内科学]