Lp(a)、D-D联合LAD对房颤并发LATH的诊断价值  

Diagnostic value of LP(a),D-D combined LAD for LATH in atrial fibrillation

作　　者：潘宏彬[1] 罗秀锋[1] 曾莲[1] 石梦菊 PAN Hong-bin;LUO Xiu-feng;ZENG Lian;SHI Meng-ju(Department of Cardiology,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin,Guangxi,541004,China)

机构地区：[1]广西壮族自治区南溪山医院心血管内科,广西桂林541004

出　　处：《心血管康复医学杂志》2023年第6期600-603,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究左房内径(LAD)、D-二聚体(D-D)联合脂蛋白(a)[Lp(a)]对房颤(AF)并发左心房血栓(LATH)的诊断价值。方法:依据食管超声心动图结果,于我院治疗的367例AF患者被分为LATH组(67例)与无LATH组(300例)。比较两组一般临床资料、LAD、血清Lp(a)水平、D-D阳性率及上述指标对AF并发LATH的诊断价值。结果:与无LATH组比较,LATH组LAD[(40.93±4.69)mm比(44.65±4.31)mm]、血清Lp(a)水平[(17.05±2.31)mg/dl比(27.42±3.06)mg/dl]、D-D阳性比例(5.67%比22.34%)均显著升高(P均=0.001)。ROC曲线显示,Lp(a)、D-D阳性、LAD及三项联合检测诊断AF并发LATH的曲线下面积(AUC)分别为:0.711、0.584、0.728、0.801,灵敏度分别为43.28%、22.39%、64.18%、65.67%,特异度分别为92.00%、94.33%、76.67%、80.67%;三项联合检测的AUC显著高于各项单独检测,灵敏度、特异度显著高于Lp(a)、D-D阳性单独检测(P<0.05或<0.01)。结论:Lp(a)、D-D阳性、LAD联合检测对房颤并发左心房血栓具较高诊断价值。Objective:To study diagnostic value of left atrial diameter(LAD),lipoprotein(a)[LP(a)]combined D-dimer(D-D)for left atrial thrombus(LATH)in patients with atrial fibrillation(AF).Methods:According to results of transesophageal echocardiography,a total of 367 AF patients treated in our hospital were divided into LATH group(n=67)and no LATH group(n=300).General clinical data,LAD,serum Lp(a)level and positive D-D rate were compared between two groups,and diagnostic value of above indexes for LATH in AF was analyzed.Results:Compared with no LATH group,there were significant rise in LAD[(40.93±4.69)mm vs.(44.65±4.31)mm],serum Lp(a)level[(17.05±2.31)mg/dl vs.(27.42±3.06)mg/dl]and positive D-D rate(5.67%vs.22.34%)in LATH group(P=0.001 all).ROC curve indicated that AUC of Lp(a),positive D-D,LAD single detection and triple combined detection diagnosing LATH in AF was 0.711,0.584,0.728 and 0.801 respectively;sensitivity was 43.28%,22.39%,64.18% and 65.67% respectively;and specificity was 92.00%,94.33%,76.67% and 80.67%respectively.AUC of triple combined detection was significantly higher than that of any single detection,and sensitivity and specificity were significantly higher than those of Lp(a)and positive D-D single detection(P<0.05 or<0.01).Conclusion:Combined detection of Lp(a),positive D-D and LAD possess high diagnostic value for left atrial thrombus in atrial fibrillation.

关 键 词：心房颤动 血栓形成 脂蛋白(A) 

分 类 号：R541.75[医药卫生—心血管疾病]