经食管超声心动图检测心房颤动患者左心耳血栓形成的价值研究  

Value of transesophageal echocardiography in the detection of left atrial appendage thrombosis in patients with atrial fibrillation

作　　者：贾利平[1] 周少华 贾琼玮 JIA Liping;ZHOU Shaohua;JIA Qiongwei(Department of Ultrasound,Yiwu Central Hospital,Yiwu 320000,China)

机构地区：[1]义乌市中心医院超声科,322000

出　　处：《心电与循环》2023年第5期478-480,484,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨经食管超声心动图(TEE)检测心房颤动(AF)患者左心耳(LAA)血栓形成的价值。方法选取2019年7月至2022年6月在义乌市中心医院行TEE检查的120例AF患者为研究对象,根据TEE检查结果显示有血栓(血栓组)48例,无血栓(无血栓组)72例。比较两组患者LAA各项参数[LAA开口内径(LAA-D)、LAA长度(LAA-L)、LAA排空速度(LAA-EV)、LAA充盈速度(LAA-FV)]和LAA形态及分叶情况。结果与无血栓组比较,血栓组患者LAA-D明显增加,LAA-EV、LAA-FV均明显减小,差异均有统计学意义(均P<0.05);两组患者LAA-L、LAA形态及分叶情况比较比较,差异均无统计学意义(均P>0.05)。LAA-D、LAA-EV、LAA-FV预测LAA血栓形成的AUC分别为0.638、0.744、0.652,差异均有统计学意义(均P<0.05);其截断值、灵敏度、特异度分别为18.82 mm、0.917、0.781,45.66 cm/s、0.708、0.613以及26.08 cm/s、0.825、0.715。结论TEE检测可以评估LAA功能,对AF患者LAA血栓形成风险具有一定的预测价值。Objective To investigate the value of transesophageal echocardiography(TEE)in detection of left atrial appendage(LAA)thrombosis in patients with atrial fibrillation(AF).Methods One hundred and twenty AF patients who underwent TEE in Yiwu Central Hospital from July 2019 to June 2022 were selected and divided into thrombotic group(n=48)and non-thrombotic group(n=72)according to TEE results.LAA indicators[LAA orifice diameter(LAA-D),LAA length(LAA-L),LAA emptying velocity(LAA-EV),LAA filling velocity(LAA-FV)],LAA morphology and lobulation were compared between the two groups.Results Compared with non-thrombotic group,LAA-D increased,LAA-EV and LAA-FV decreased significantly in thrombotic group(all P<0.05).There was no significant difference in LAA-L,LAA morphology and lobulation between the two groups(all P>0.05).The AUC of LAA-D,LAA-EV and LAA-FV for predicting LAA thrombosis were 0.638,0.744 and 0.652,respectively,the cut-off values were 18.82 mm,45.66 cm/s and 26.08 cm/s,the sensitivity were 0.917,0.708 and 0.825,the specificity was 0.781,0.613 and 0.715,respectively.Conclusion Transesophageal echocardiography can evaluate LAA function and has certain predictive value for the risk of LAA thrombosis in AF patients.

关 键 词：经食管超声心动图 心房颤动 左心耳 血栓形成 

分 类 号：R541.75[医药卫生—心血管疾病] R540.45[医药卫生—内科学]