血清白蛋白预测老年非瓣膜性房颤患者左心房血栓形成的临床价值  

Clinical value of serum albumin in the evaluation of left atrial thrombosis in patients with nonvalvular atrial fibrillation

作　　者：雷志博 张智文 曹选超 杨新颖[1] 刘祥 黄改荣 Lei Zhibo;Zhang Zhiwen;Cao Xuanchao;Yang Xinying;Liu Xiang;Huang Gairong(Department of Geriatrics,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南大学人民医院河南省人民医院老年医学科,郑州450003

出　　处：《中华老年医学杂志》2021年第8期996-999,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨血清白蛋白(SA)水平与老年非瓣膜性房颤(NVAF)患者左心房血栓(LAT)形成的关系,评价其预测老年NVAF患者LAT形成的临床价值。方法回顾性分析在我院接受经食道超声心动图(TEE)检查的180例老年NVAF患者的临床资料,按照左心房是否有血栓,将患者分为血栓组(42例)和非血栓组(138例)。分析两组患者的一般临床资料,采用Logistic回归方程分析老年NVAF患者左心耳血栓形成的相关因素,使用受试者工作特征曲线(ROC)评价血清白蛋白水平预测老年NVAF患者LAT形成的价值。结果血栓组患者房颤病程长于非血栓组(P<0.05);血栓组C-反应蛋白(CRP)和血小板计数(PLT)高于非血栓组(P<0.05),SA和国际标.准化比值(INR)则低于非血栓组(P<0.05);血栓组左心房内径(LAD)高于非血栓组(P<0.05);多元Logistics回归显示,房颤病程和CRP是LAT形成的独立危险因素(均P<0.05),SA和INR是LAT形成的独立保护因素(均P<0.05)。ROC曲线显示SA预测LAT形成的曲线下面积(AUC)为0.778(95%CI:0.711~0.837,P<0.001)。结论SA与老年NVAF患者LAT形成密切相关,可将其视为1种LAT形成的预测因子,应监测患者SA水平以降低房颇患者卒中事件的发生率。Objective To investigate the relationship between serum albumin (SA)levels and left atrial thrombosis(LAT)in elderly patients with nonvalvular atrial fibrillation(NVAF),and to evaluate the clinical value of SA in predicting LAT in elderly NVAF patients.Methods Clinical data of 180 elderly patients with NVAF undergone transesophageal echocardiography(TEE)in our hospital were retrospectively analyzed.According to whether there was thrombosis in the left atrium,patients were divided into the thrombus group(n=42)and the non-thrombus group(n=138).Logistic regression was used to analyze factors related to left atrial appendage thrombosis in NVAF patients.The receiver operating characteristic(ROC)curve was used to evaluate the value of serum albumin levels in predicting LAT formation in elderly NVAF patients.Results The duration of AF was longer in the thrombus group than in the non-thrombus group(all P<0.05).C-reactive protein(CRP)levels and platelet(PLT)counts were higher,and SA levels and the international normalization ratio(INR)were lower in the thrombus group than in the non-thrombus group(all P<0.05).The left atrial diameter(LAD)was larger in the thrombus group than in the non-thrombus group(P<0.05).Multiple Logistic regression analysis showed that the duration of AF and CRP levels were independent risk factors for LAT(P<0.05),and SA levels and INR were independent protective factors for LAT(P<0.05).ROC curve results showed that the area under the curve(AUC)of SA in predicting LAT was 0.778(95%CI:0.711-0.837,P<0.001).Conclusions Low serum albumin levels are closely related to LAT in NVAF patients and can be regarded as a predictor of LAT.Serum albumin levels should be monitored in clinical practice to reduce the incidence of stroke events in patients with AF.

关 键 词：白蛋白类 心房颤动 血栓形成 

分 类 号：R541.75[医药卫生—心血管疾病]