非瓣膜性房颤患者左心房结构与左心耳自发显影、左心耳血栓的相关性研究  

Relationship among left atrial structure,left atrial appendage spontaneous echo contrast and left atrial appendage thrombus in patients with non-valvular atrial fibrillation

作　　者：郭辉辉 宋瑞 李柏林 李锡洋 刘辉 孙超峰[3] 李红兵[3] Guo Huihui;Song Rui;Li Bolin;Li Xiyang;Liu Hui;Sun Chaofeng;Li Hongbing(Health Management Center of Yulin NO.2 Hospital,Yulin 719000,China.;不详)

机构地区：[1]榆林市第二医院健康管理中心,榆林1719000 [2]榆林市第二医院内分泌科,719000榆林 [3]西安交通大学第一附属医院心血管内科,西安710061 [4]西安交通大学第一附属医院生物样本信息资源中心,西安4710061

出　　处：《中国循证心血管医学杂志》2022年第7期839-843,847,共6页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：西安交通大学第一附属医院临床研究课题重点项目(XJTU1AF-CRF-2015-007)。

摘　　要：目的探索非瓣膜性房颤(NVAF)患者左心房(LA)结构指标与左心耳自发显影(LAASEC)、左心耳血栓(LAAT)的相关性。方法收集2016年3月1日至2019年12月31日于西安交通大学第一附属医院心内科住院的NVAF患者,以经食道超声(TEE)所示左心耳(LAA)情况分为:血栓组42例、自发显影(SEC)组69例和对照组(无LAASEC或LAAT)273例。分析NVAF患者的LA结构指标与LAASEC、LAAT的相关性。结果LAA开口径(OR=1.208,95%CI:1.094~1.333,P<0.001),LAA血流速度<40 cm/s(OR=72.329,95%CI:24.065~217.392,P<0.001)、LA左右径(OR=1.037,95%CI:1.010~1.065,P=0.008)、LA上下径(OR=1.071,95%CI:1.029-1.116,P=0.001)、RSPV与RIPV间距(OR=1.089,95%CI:1.019~1.163,P=0.012)、RSPV与LSPV间距(OR=1.034,95%CI:1.004~1.066,P=0.027)均是LAASEC的独立危险因素;LAA血流速度<40 cm/s(OR=15.268,95%CI:6.652~35.045,P<0.001)是LAAT的独立危险因素。结论临床中应对有上述危险因素的NVAF患者重点关注,及早干预,以减少脑卒中的发生。Objective To investigate the relationship among left atrial structure indexes,left atrial appendage spontaneous echo contrast(LAASEC)and left atrial appendage thrombus(LAAT)in patients with non-valvular atrial fibrillation(NVAF).Methods NVAF patients were chosen from Department of Cardiology in the First Affiliated Hospital of Xi`an Jiaotong University from Mar.1,2016 to Dec.31,2019.All patients were divided,according to the status of left atrial appendage(LAA)shown by transesophageal echocardiography(TEE),into thrombus group(n=42),spontaneous echo contrast group(SEC group,n=69)and control group(no LAASEC or no LAAT,n=273).The left atrial structure indexes,and correlation among them and LAASEC and LAAT were analyzed.Results LAA open caliber(OR=1.208,95%CI:1.094~1.333,P<0.001),LAA flow velocity<40 cm/s(OR=72.329,95%CI:24.065~217.392,P<0.001),left atrial mediolateral diameter(OR=1.037,95%CI:1.010~1.065,P=0.008),left atrial suproinferior diameter(OR=1.071,95%CI:1.029~1.116,P=0.001),the interval between right superior pulmonary vein(RSPV)and right inferior pulmonary vein(RIPV,OR=1.089,95%CI:1.019~1.163,P=0.012),and interval between RSPV and left superior pulmonary vein(LSPV,OR=1.034,95%CI:1.004~1.066,P=0.027)all were independent risk factors of LAASEC.LAA flow velocity<40 cm/s(OR=15.268,95%CI:6.652~35.045,P<0.001)was an independent risk factor of LAAT.Conclusion In clinical practice,more attention should be paid to NVAF patients with the above risk factors,and early intervene will reduce stroke incidence.

关 键 词：心房颤动 左心耳自发显影 左心耳血栓 左心房结构 肺静脉 

分 类 号：R541.75[医药卫生—心血管疾病]