计算机断层摄影术心脏成像评价不同类型心房颤动患者左心房内形态结构的临床研究  

The left atrium anatomical structure in patients with different types of atrial fibrillation evaluated by 256-slice spiral cardiac CTA

作　　者：王喆 江耀辉 张悦坤 陈晓杰[1] 陈英伟[1] 孙莉萍 董建增[1,2] WANG Zhe;JIANG Yaohui;ZHANG Yuekun;CHEN Xiaojie;CHEN Yingwei;SUN Liping;DONG Jianzeng(Department of Cardiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou,450052,China;Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University)

机构地区：[1]郑州大学第一附属医院心内科,郑州450052 [2]首都医科大学附属北京安贞医院心内科

出　　处：《临床心血管病杂志》2020年第12期1130-1134,共5页Journal of Clinical Cardiology

基　　金：国家重点研发计划(No:2016YFC1301000)。

摘　　要：目的:应用256层螺旋计算机断层摄影术(CT)心脏成像定量测定心房颤动(房颤)患者左心房内形态结构的相关参数,探讨不同类型房颤患者左心房内形态结构的差异。方法:选取2018年6月—2018年12月于郑州大学第一附属医院住院的98例房颤患者为研究对象,其中阵发性房颤55例(56.1%,阵发性房颤组),持续性房颤43例(43.9%,持续性房颤组),均行256层螺旋CT心脏检查。通过对CT图像的处理来测量左心房体积,左心耳嵴长度和上缘、中部、下缘宽度,肺静脉嵴间部前缘、中部、后缘宽度,左心耳体积,左心耳开口面积,肺静脉开口面积。比较两组基线资料的差异,并分析不同类型心房颤动患者左心房内形态结构的差异。结果:两组患者在性别、吸烟、高血压、脑血管病、冠心病、血小板、血红蛋白、年龄、BMI、左心房体积、左侧肺静脉嵴间宽度、左心耳嵴长度和宽度、左心耳和肺静脉开口面积大小等方面均差异无统计学意义。持续性房颤组患者左房内径,右侧肺静脉嵴间前缘、中部、后缘宽度,左心耳体积均显著大于阵发性房颤组(均P<0.05)。结论:与阵发性房颤患者相比,持续性房颤患者左房内径、右侧肺静脉嵴间宽度、左心耳体积均明显增大,两者左心房体积、左侧肺静脉嵴间宽度、左心耳嵴长度和宽度、左心耳开口面积、肺静脉开口面积无明显差异。Objective:To investigate the left atrium anatomical structure in different subtypes of atrial fibrillation(AF)based on quantitative measurement using 256-slice spiral cardiac CTA.Method:Ninety-eight AF patients in our hospital from June 2018 to December 2018 were enrolled,including 55 cases with paroxysmal AF(PAF group)and 43 cases with persistent AF(PeAF group).All patients underwent 256-slice spiral cardiac CTA.Left volume(LV),laft atrial diameter,the length of left atrial appendage(LAA)ridge,superior border,middle part,inferior marign width of the LAA ridge,anterior,medium,posterior marign width of the lateral pulmonary ridges,LAA volume,LAA orifices area,the orifice area of the pulmonary vein in the left atrium were measured using cardiology CT post-processing software.The differences between the two groups were compared,and the differences of left atrium morphology in different types of AF were analyzed.Result:There was no significant difference between the two groups in sex,smoking,hypertension,cerebrovascular disease,coronary heart disease,platelet,hemoglobin,age,BMI,left atrial volume,the anterior,medium,posterior width of left pulmonary ridge,the length and superior border,middle part,inferior marign width of LAA ridge,LAA volume,the orifices area of LAA,and pulmonary veins in the left atrium.The anterior,medium,posterior width of right pulmonary ridge,left atrial diameter and LAA volume in the PeAF group were all larger than those in the PAF group(all P<0.05).Conclusion:The width of the right pulmonary ridge,left atrial diameter,and LAA volume in patients with persistent AF are larger than those in paroxysmal AF.There is no difference in LA volume,the width of left pulmonary ridge,the length and width of the LAA ridge,the orifice area of LAA,and pulmonary veins between the two groups.

关 键 词：心房颤动 左心房 形态结构 

分 类 号：R541.7[医药卫生—心血管疾病]