左心耳形态及功能与非瓣膜性心房颤动患者发生缺血性脑卒中的相关性  

Correlation between left atrial appendage morphology and function and risk of ischemic stroke

作　　者：周少华 龚丹[2] 贾利平[1] ZHOU Shaohua;GONG Dan;JIA Liping(Department of Ultrasound,Yiwu Central Hospital,Yiwu 322000,China;Department of Radiology,Yiwu Central Hospital,Yiwu 322000,China)

机构地区：[1]义乌市中心医院超声科,浙江义乌322000 [2]义乌市中心医院放射科,浙江义乌322000

出　　处：《健康研究》2023年第5期574-578,共5页Health Research

基　　金：义乌市科技计划项目(21-3-70)。

摘　　要：目的观察非瓣膜性心房颤动(NVAF)患者的左心耳影像学检查下形态、功能,分析其与发生缺血性脑卒中的相关性,以期为临床早发现、早干预提供依据。方法收集NVAF患者作为研究对象,采用CT影像学检查患者左心耳情况,应用经食管超声心动图(TEE)检查测定左心耳功能,采用Spearman秩分析探究左心耳体积、功能与缺血性脑卒中发生风险的相关性。结果共纳入符合条件的患者350例,缺血性脑卒中组的年龄、左心耳体积、CHA_(2)DS_(2) VASc评分、持续性房颤的占比大于/高于非缺血性脑卒中组,差异有统计学意义(P<0.05)。缺血性脑卒中组的左心耳形态为仙人掌型、菜花型的占比(27.86%、21.43%)高于非缺血性脑卒中组(12.38%、8.09%),LAAEF、LAA-PEV、LAA-PFV均低于非缺血性脑卒中组,差异均有统计学意义(P<0.05);两组的左心耳开口形态(圆形、椭圆形、三角形)分布的占比,差异无统计学意义(Z=0.916,P=0.360)。Spearman秩分析显示,年龄、CHA_(2)DS_(2) VASc评分、左心耳体积与缺血性脑卒中的发生呈正相关(r=0.377、0.772、0.625,均P<0.05),LAAEF、LAA-PEV、LAA-PFV与缺血性脑卒中的发生呈负相关(r=-0.789、-0.335、-0.420,均P<0.05)。结论左心耳的形态、功能与缺血性脑卒中的发生具有一定相关性,左心耳相关检查有助于预测NVAF患者发生缺血性脑卒中的风险。Objective To study the correlation between the morphology and function of left atrial appendage under imaging examination and the risk of ischemic stroke in patients with non-valvular atrial fibrillation(NVAF),in order to provide a basis for early clinical detection and early intervention.Methods Patients with NVAF were collected as subjects.CT imaging was used to examine the left atrial appendage of patients.Transesophageal echocardiography(TEE)was used to measure the function of the left atrial appendage.Spearman rank analysis was used to explore the correlation between the volume and function of the left atrial appendage and the risk of ischemic stroke.Results A total of 350 eligible patients were included.The age,left atrial appendage volume,CHA_(2)DS_(2)VASc score,and proportion of persistent atrial fibrillation in the ischemic stroke group were greater than/higher than those in the non-ischemic stroke group,and the differences were statistically significant(P<0.05).The proportion of cactus-type and cauliflower-type left atrial appendage in the ischemic stroke group(27.86%,21.43%)was higher than that in the non-ischemic stroke group(12.38%,8.09%).LAAEF,LAA-PEV and LAA-PFV were lower than those in the non-ischemic stroke group,and the differences were statistically significant(P<0.05).There was no significant difference in the proportion of left atrial appendage opening morphology(circular,elliptical,triangular)distribution between the two groups(Z=0.916,P=0.360).Spearman rank analysis showed that age,CHA_(2)DS_(2)VASc score and left atrial appendage volume were positively correlated with the occurrence of ischemic stroke(r=0.377,0.772,0.625,all P<0.05),while LAAEF,LAA-PEV and LAA-PFV were negatively correlated with the occurrence of ischemic stroke(r=-0.789,-0.335,-0.420,all P<0.05).Conclusions The morphology and function of left atrial appendage have a certain correlation with the occurrence of ischemic stroke.The examination of left atrial appendage is helpful to predict the risk of ischemic stroke in NVAF

关 键 词：左心耳 缺血性脑卒中 超声心动图 相关性 

分 类 号：R322.11[医药卫生—人体解剖和组织胚胎学]