左心房CT参数对房颤射频消融术后复发的预测价值  

Predictive value of left atrium CT index for recurrence of atrial fibrillation after radiofrequency ablation

作　　者：阿不都乃比·阿不都尔依木 艾克白尔·吐逊[2] 祖丽菲亚·买合木提 阿布都克力木·玉苏甫 伊米古丽·伊敏 ABUDUNAIBI Abudueryimu;AIKEBAIER Tuxun;ZULIFEIYA Maihemuti;ABUDUKELIMU Yusufu;YIMIGULI Yimin(Department of Imaging,Kashi Prefecture Second People’s Hospital,Xinjiang 844000,China)

机构地区：[1]喀什地区第二人民医院影像中心,新疆喀什844000 [2]喀什地区第一人民医院骨科,新疆喀什844000

出　　处：《影像诊断与介入放射学》2021年第6期432-436,共5页Diagnostic Imaging & Interventional Radiology

基　　金：喀什地区应用技术研究与开发计划(KS2020015)。

摘　　要：目的研究左心房(LA)相关CT参数对心房颤动射频消融术后复发的预测价值。方法选择2019年5月~2020年5月接受射频消融治疗的80例房颤患者,随访术后1年房颤复发情况并分为复发组(n=28)和未复发组(n=52)。比较两组患者术前LA容积(LAV)、LAA容积(LAAV)、LAA开口面积(LAA CSA)、右上PV开口面积(RSPV CSA)、右下PV开口面积(RIPV CSA)、左上PV开口面积(LSPV CSA)、左下PV开口面积(LIPV CSA)的差异,采用ROC曲线分析不同指标对房颤复发的预测价值。结果复发组的LSPV CSA、RSPV CSA、LIPV CSA、RIPV CSA、LAA CSA水平与未复发组比较无统计学差异(P>0.05),LAV(102.24±17.96)ml、LAAV(11.70±2.97)ml均高于未复发组的LAV(88.93±16.34)ml、LAAV(9.78±2.17)ml(t=3.353、3.308,P均为0.001);LAV、LAAV单一指标均对房颤复发具有预测价值,ROC曲线下面积分别为0.727、0.699(P=0.001、0.003);将Logistic回归模型中生成LAV联合LAAV预测房颤复发的方程作为新指标,新指标对房颤复发具有预测价值、ROC曲线下面积0.756(P<0.001),预测效能优于单一指标。结论LA成像参数LAV、LAAV对房颤射频消融术后复发具有预测价值,并且LAV联合LAAV预测的效能优于单一指标。Objective To study the predictive value of left atrium(LA)CT index for recurrence of atrial fibrillation after radiofrequency ablation(RFA).Methods From May 2019 to May 2020,80 patients with atrial fibrillation received RFA in our hospital were followed up for 1 year.They were divided into recurrence(28)and non-recurrence(52)groups.The preoperative LA volume(LAV),left atrial appendage(LAA)volume(LAAV),LAA cross-sectional area(CSA),right superior pulmonary vein(RSPV)CSA,right inferior pulmonary vein(RIPV)CSA,left superior pulmonary vein(LSPV)CSA,and left inferior pulmonary vein(LIPV)CSA were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of different indexes for recurrence of atrial fibrillation.Results There was no significant difference in LSPV CSA,RSPV CSA,LIPV CSA,RIPV CSA and LAA CSA between the recurrence and non-recurrence groups(P>0.05).The LAV(102.24±17.96)ml and LAAV(11.70±2.97)ml in the recurrence group were significantly higher(P<0.05)than that in the non-recurrence group[(88.93±16.34)ml,(9.78±2.17)ml].LAV and LAAV could predict the recurrence of atrial fibrillation with areas under the ROC curves(AUC)of 0.727(P=0.001)and 0.699(P=0.003),respectively.The equation of LAV combined with LAAV generated from logistic regression model was used as a new index with AUC of 0.756(P<0.001)and had better predictive efficiency than either index alone.Conclusion LAV and LAAV can predict recurrence of atrial fibrillation after RFA.The predictive efficiency of LAV combined with LAAV is better than either index alone.

关 键 词：心房颤动 射频消融术 复发 预测 左心房容积 左心耳容积 

分 类 号：R541.75[医药卫生—心血管疾病] R814.42[医药卫生—内科学]