左房自发性显影的相关因素及临床预测价值的研究

发布时间：2018-09-09 19:39

【摘要】：目的:探讨经食管超声检查的心房颤动(房颤)患者左房或左心耳自发性显影形成的相关因素,为临床进行风险评估、指导治疗提供依据。方法:选取该院2011-2014年未进行正规华法林抗凝的113例房颤患者,均行经食管超声心动图检查,将符合标准的92例患者根据是否存有左房自发性显影分为LASEC阳性组和LASEC阴性组,回顾性对比分析两组的临床特征及超声心动图参数,对结果进行多因素分析及诊断价值评估。结果:两组间在房颤类型(持续性)、高血压、左心房内径,左室舒张功能中有显著差异(P0.05),其中持续性房颤、左心房内径40mm、高血压病有极显著差异(P0.01)。CHA2DS2-VASC评分、血浆D-二聚体对LASEC的房颤患者有预测价值。结论:持续性房颤患者LASEC的发生率较高,多合并血栓形成(44%)。LASEC形成的影响因素包括:持续性房颤、左心房内径40mm、高血压、左室舒张功能差;CHA2DS2-VASC评分、D-二聚体对LASEC的形成有临床预测价值。
[Abstract]:Objective: to investigate the related factors of spontaneous development of left atrial or atrial appendage in patients with atrial fibrillation (AF) examined by transesophageal ultrasound, and to provide evidence for clinical risk assessment and treatment guidance. Methods: 113 patients with atrial fibrillation who did not undergo regular warfarin anticoagulation in our hospital from 2011 to 2014 were examined by transesophageal echocardiography. According to the criteria, 92 patients were divided into LASEC positive group and LASEC negative group according to the existence of left atrial spontaneous development. The clinical features and echocardiographic parameters of the two groups were analyzed retrospectively, and the results were evaluated by multivariate analysis and diagnostic value. Results: there were significant differences between the two groups in atrial fibrillation type (persistence), hypertension, left atrial diameter, left ventricular diastolic function (P0.05). Among them, persistent atrial fibrillation, left atrial diameter 40 mm, essential hypertension (P0.01) .CHA2DS2-VASC score were significantly different between the two groups. Plasma D-dimer can predict atrial fibrillation in patients with LASEC. Conclusion: the incidence of LASEC in patients with persistent atrial fibrillation is high. The factors influencing the formation of thrombus (44%) .LASEC include persistent atrial fibrillation, 40 mm left atrial diameter and hypertension. Left ventricular diastolic dysfunction and CHA 2 DS 2-VASC score D-dimer has clinical predictive value for the formation of LASEC.
【作者单位】：天津医科大学第二医院心脏科;
【分类号】：R541.75;R540.45

【参考文献】