二尖瓣钙化、血清hs⁃CRP和cysc水平对风心病患者左房血栓形成的预测价值  

Predictive value of mitral valve calcification,serum hs⁃CRP and Cysc levels for left atrial thrombosis in patients with rheumatic heart disease

作　　者：刘汉多 帕丽莎·阿里木 周华涛[1] LIU Han-duo;PALISHA Alimu;ZHOU Hua-tao(Department of Cardiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangdong,510120;Emergency Department,Beixing Health Center,Huadong Town,Huadu District,Guangzhou;Emergency Department,Sun Yat-sen Memorial Hospital,Sun Yat-sen University)

机构地区：[1]中山大学孙逸仙纪念医院心内科,510120 [2]广州市花都区花东镇北兴卫生院急诊科 [3]中山大学孙逸仙纪念医院急诊科

出　　处：《岭南急诊医学杂志》2022年第5期412-414,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨如何运用临床资料对风心病患者左心房血栓(LAT)形成做出初步预测。方法:收集2019年1月至2021年12月因风心病于中山大学孙逸仙纪念医院行瓣膜置换手术的患者64例。根据术中解剖分为LAT组18例,无LAT组46例。通过病理评估瓣膜钙化情况,同时记录临床资料。结果:LAT组二尖瓣瓣口面积更小、持续性房颤比例更高,组间差异具有统计学意义(P<0.05)。LAT组二尖瓣钙化13例(72.2%),无LAT组二尖瓣钙化为24例(52.2%),差异具有统计学意义(P<0.05)。LAT组hs⁃CRP、Cysc水平均明显高于无LAT组,组间差异具有统计学意义(P<0.05)。多因素logistic回归分析显示,二尖瓣钙化、hs⁃CRP及Cysc均是左心房血栓形成的独立危险因素。二尖瓣钙化联合hs⁃CRP及Cysc水平曲线下面积。结论:LAT组患者二尖瓣钙化率更高,hs⁃CRP联合Cysc能较好预测风心病患者左心房血栓形成的风险。Objective:To explore the method to predict the formation of left atrial thrombosis(LAT)in patients with rheumatic heart disease with clinical data.Methods:A total of 64 patients with rheumatic heart disease who under⁃went valve replacement surgery in Sun Yat⁃sen Memorial Hospital of Sun Yat⁃sen University from January 2019 to De⁃cember 2021 were collected.According to the anatomy,the patients were divided into LAT group(n=18)and non⁃LAT group(n=46).Valve calcification was evaluated by pathology and clinical data were recorded.Results:The mitral valve orifice area was smaller and the proportion of persistent atrial fibrillation was higher in the LAT group,and the differ⁃ence between the groups was statistically significant(P<0.05),which was consistent with other previous studies[5].There were 13 cases(72.2%)of mitral valve calcification in LAT group and 24 cases(52.2%)of mitral valve calcifica⁃tion in non⁃LAT group,and the difference was statistically significant(P<0.05).The levels of hs⁃CRP and Cysc in LAT group were significantly higher than those in no LAT group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that mitral valve calcification,hs⁃CRP and Cysc were independent risk factors for LAT.Area under curve of mitral valve calcification combined with hs⁃CRP and Cysc levels.Conclusion:The rate of mitral valve calcification is higher in patients with LAT,and hs⁃CRP combined with Cysc can better predict the risk of left atrial thrombosis in patients with rheumatic heart disease.

关 键 词：风湿性心脏病 左心房血栓 二尖瓣钙化 hs⁃CRP CYSC 

分 类 号：R541.5[医药卫生—心血管疾病]