经食管三维超声心动图对不同类型心房颤动患者左心耳结构及功能的评价价值分析  

Analysis of the evaluation value of three-dimensional transesophageal echocardiography on the structure and function of the left atrial appendage in patients with different types of atrial fibrillation

作　　者：李韵 何艺施 覃雨菲 黄灿斌 陈子然 LI Yun;HE Yi-shi;QIN Yu-fei(Ultrasound Department,Panyu Central Hospital Affiliated to Guangzhou Medical University,Guangzhou 511400,China)

机构地区：[1]广州医科大学附属番禺中心医院超声科,511400

出　　处：《中国现代药物应用》2024年第24期62-65,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探究经食管三维超声心动图(3DTEE)评价不同类型心房颤动(AF)患者左心耳(LAA)结构及功能的价值。方法 选取129例AF患者作为研究对象,根据AF类型将患者分为持续性AF组(n=98)与长程持续性AF组(n=31)。所有患者均进行3DTEE检查,比较两组LAA的分叶情况、各径线[LAA开口长径(LAA-D1)、LAA开口短径(LAA-D2)]以及功能参数[LAA收缩末期容积(LAA-ESV)、LAA舒张末期容积(LAA-EDV)、左心耳射血分数(LAA-EF)、LAA峰值应变(LAA-S)],绘制受试者工作特征曲线(ROC曲线)分析3DTEE参数在不同类型AF患者中的诊断效能。结果 持续性AF组患者LAA单叶、2叶、3叶、4叶分别为10、52、27、9例,长程持续性AF组LAA单叶、2叶、3叶、4叶分别为3、18、6、4例;两组LAA分叶情况比较未见显著差异(P>0.05)。两组LAA-D1和LAA-D2比较未见显著差异(P>0.05)。长程持续性AF组的LAA-ESV(3.17±0.88)ml、LAA-EDV(5.43±1.48)ml大于持续性AF组的(2.84±0.59)、(4.87±1.15)ml, LAA-EF(37.74±5.13)%、LAA-S(11.75±2.08)低于持续性AF组的(41.97±5.28)%、(14.66±2.12)(P<0.05)。ROC曲线分析结果显示:LAA-S的曲线下面积(AUC)最高,为0.812,敏感度、特异度分别为83.87%、72.45%;LAA-EDV的AUC最低,为0.500,敏感度、特异度分别为38.71%、78.57%。结论 3DTEE可对不同类型AF患者的LAA结构及功能进行评估,且LAA-S在不同类型AF中具有较好的诊断效能,可用于临床推广。Objective To explore the value of three-dimensional transesophageal echocardiography(3DTEE)on the structure and function of the left atrial appendage(LAA)in patients with different types of atrial fibrillation(AF).Methods 129 patients with AF were selected as the study subjects,and the patients were categorized into the persistent AF group(n=98)and the long-term persistent AF group(n=31)according to the types of AF.All patients underwent 3DTEE to compare the lobulations of the LAA,each diameters[LAA opening long diameter(LAA-D1),LAA opening short diameter(LAA-D2)],and functional parameters[LAA end-systolic volume(LAA-ESV),LAA end-diastolic volume(LAA-EDV),LAA ejection fraction(LAA-EF),LAA peak strain(LAA-S)];the receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic efficacy of 3DTEE parameters in patients with different types of AF.Results There were 10,52,27,and 9 cases of single-lobed,2-lobed,3-lobed,and 4-lobed LAA in the persistent AF group,and 3,18,6,and 4 cases of single-lobed,2-lobed,3-lobed,and 4-lobed LAA in the long-term persistent AF group;there was no significant difference in comparison of LAA lobulation between the two groups(P>0.05).There was no significant difference in comparison of LAA-D1 and LAA-D2 between the two groups(P>0.05).LAA-ESV of(3.17±0.88)ml and LAA-EDV of(5.43±1.48)ml in the long-term AF group were greater than(2.84±0.59)and(4.87±1.15)ml in the persistent AF group;LAA-EF of(37.74±5.13)%and LAA-S of(11.75±2.08)in the long-term AF group were lower than(41.97±5.28)%and(14.66±2.12)in the persistent AF group(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of LAA-S was the highest(0.812),and the sensitivity and specificity were 83.87%and 72.45%;the AUC of LAA-EDV was the lowest(0.500),and the sensitivity and specificity were 38.71%and 78.57%.Conclusion 3DTEE can evaluate the structure and function of the LAA in patients with different types of AF,and LAA-S shows good diagnostic efficacy in different types of AF,which can be

关 键 词：持续性心房颤动 长程持续性心房颤动 经食管三维超声心动图 超声参数 左心耳 

分 类 号：R54[医药卫生—心血管疾病]