心房颤动患者左心耳血栓形成的超声预测因素  

Echocardiographic predictors of left atrial appendage thrombus formation in patients with atrial fibrillation

作　　者：李燕玲[1] 谢萍[1] 吴怡 郭朝霞[1] 高奋堂[1] Li Yan-ling;Xie Ping;Wu Yi;Guo Zhao-xia;Gao Feng-tang(Department of Cardiology,Gansu Provincial Hospital,Lanzhou 730000,China;School of Public Health,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院心内科,甘肃兰州730000 [2]兰州大学公共卫生学院,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2022年第7期30-34,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省国际科技合作资助项目(20YF3WA011)。

摘　　要：目的 探讨非瓣膜性心房颤动(NVAF)患者左心耳血栓形成的超声预测因素。方法 对甘肃省人民医院心内科拟行导管消融术的160例NVAF患者依经食管超声心动图分为左心耳血栓组和无血栓组,比较其临床资料、实验室指标及经胸超声心动图参数,Logistic回归分析筛选左心耳血栓形成的影响因素,并以受试者工作特征曲线评价其预测效力。结果 2组患者的年龄、性别、阵发性房颤占比差异均无统计学意义(P>0.05)。与无血栓组比较,血栓组患者糖尿病比例、心力衰竭比例、脑梗死比例、D-二聚体水平及左心房内径(LAD)均更高,左室射血分数(LVEF)更低,差异有统计学意义(P<0.05)。Logistic回归分析显示LAD和LVEF是NVAF患者左心耳血栓形成的独立危险因素。结论 LAD是NVAF患者左心耳血栓形成强有力的影响因素,结合LVEF可进一步提高左心耳血栓形成的预测效力。Objective To explore the risk factors of left atrial appendage thrombus(LAAT) in patients with non-valvular atrial fibrillation(NVAF). Methods Totally 160 patients with NVAF for whom catheter ablation was planned were divided into the LAAT group and the non LAAT group in the Department of Cardiology of Gansu Provincial Hospital according to the results of transesophageal echocardiography. Clinical data,transthoracic echocardiography and transesophageal echocardiography findings were compared between the two groups. Risk factors of LAAT formation were analyzed by Logistic regression analysis and their predictive effectiveness was evaluated. Results There was no significant difference in age, gender and proportion of paroxysmal atrial defibrillation between the two groups. Compared with the non LAAT group, the possibility of diabetes, heart failure, cerebral infarction, D-dimer and left atrial diameter(LAD) were bigger, but left ventricular ejection fraction(LVEF) was lower in the LAAT group(P < 0.05). Further multivariate Logistic regression analysis indicated that LAD and LVEF were independent factors of LAAT. Conclusion LAD is a powerful risk factor of LAAT in patients with NVAF, and its predictive value can be enhanced when combined with LVEF.

关 键 词：非瓣膜性心房颤动 左室射血分数 左心房内径 左心耳血栓 

分 类 号：R542.4[医药卫生—心血管疾病]