心房颤动患者射频消融手术前后左心房结构及功能的对照研究

发布时间：2018-01-12 17:05

  本文关键词：心房颤动患者射频消融手术前后左心房结构及功能的对照研究　出处：《石河子大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 心房颤动 左心房 左心耳 脑钠肽 超敏C反应蛋白 经食道超声心动图

【摘要】：目的评价非风湿性心房颤动(房颤)患者射频消融手术前后左心房结构及功能的变化。方法非风湿性性房颤(Non rheumatic atrial fibrillation,NRAF)患者200例,其中100例行射频消融手术者为射频消融组,100例行药物保守治疗者为保守治疗组。2组治疗前及治疗后1 a后均行经食管超声心动图检查,和血脑钠肽(Brain natriuretic peptide,BNP)、高敏C反应蛋白(hugh C-reactive prote,hs-CRP)水平测定,比较2组左心房、左心耳结构和功能变化以及血清BNP、hs-CRP水平。结果射频消融组和保守治疗组治疗前左房内径(Left atrial diameter,LAD)[(45.3±3.2)、(45.1±2.6)mm]、左心房最大容积(Left atrial maximum volume,LAVmax)[(75.9±5.1)、(76.3±4.2)m L]、左心房容积指数(Left atial volume index,LAVI)[(97.4±8.3)、(98.3±5.1)m L/m2]、左心耳最大容积(Left atrial appendage maximum volume,LAAVmax)[(7.0±0.8)、(6.8±0.9)m L]、左心房射血数(Left atrial ejection fraction,LA-EF)[(47.5±5.6)%、(48.2±4.5)%]、左心耳射血分数(left atrial appendage ejection fraction,LAA-EF)[(17.1±2.7)%、(17.5±1.9)%]、左心耳最大排空速度[(Left atrial appendage emptying maxiumun speed,LAA-PEV)]、左心室射血分数[(left ventricular ejection fraction,LVEF)[(59±1.7)%、(59.1±2.2)%]以及血BNP[(47.1±6.5)、(46.2±8.4)ng/L]、hs-CRP[(8.54±2.21)、(7.91±3.1)mg/L]比较差异均无统计学意义(P0.05);治疗后1 a,2组以上指标均较治疗前改善,且射频消融组LAD[(35.6±3.4)mm]、LAVmax[(66.5±4.4)m L]、LAVI[(72.6±5.4)m L/m2]、LAAVmax[(4.1±0.5)m L]以及血BNP[(17.8±5.3)ng/L]、hs-CRP[(4.23±1.6)mg/L]低于保守治疗组[(39.2±2.1)mm、(72.7±3.1)m L、(89.4±2.7)m L/m2、(4.5±0.6)m L、(30.1±6.3)ng/L、(5.5±2.2)mg/L],LAA-PEV[(38.1±6.5)cm/s]、LAA-EF[(22.2±3.5)%]、LAEF[(55.6±5.3)%]、LVEF[(65±1.4)%]高于保守治疗组[(33.6±7.3)cm/s、(20.2±3.1)%、(51.1±5.7)%、(60.1±1.1)%],2组比较差异均有统计学意义(P0.05)。结论导管射频消融术可逆转NRAF患者左心房和左心耳结构及功能。
[Abstract]:Objective to evaluate the changes of left atrial structure and function in patients with non-rheumatic atrial fibrillation (AF) before and after radiofrequency ablation. Non rheumatic atrial fibrillation. Of 200 patients with NRAF, 100 underwent radiofrequency ablation. Transesophageal echocardiography was performed before and 1 year after treatment in 100 cases of conservative drug therapy in group 2. And brain natriuretic peptide (BNP), high sensitive C-reactive prote (C-reactive prote), and brain natriuretic peptide (BNP). The level of hs-CRP was measured and the changes of structure and function of left atrium and left atrial appendage and serum BNP were compared between the two groups. Results the left atrial diameter of left atrium in radiofrequency ablation group and conservative treatment group before treatment was Left atrial diameteral LAD). [Left atrial maximum volume: left atrial maximum volume LAVmax. 45.3 卤3.2mm. [Left atrial volume index (Left atial volume index LAVI). [97.4 卤8.3 卤8.1 m / m ~ (2) m ~ (-1) m ~ (-1 / m ~ (2)). Left atrial appendage maximum volume max. of left atrial appendage. [Left atrial ejection fractionation LA-EFL, Left atrial ejection fractionation (Left atrial ejection fractionation LA-EFL), left atrial ejection number (Left atrial ejection fractionation LA-EFL). [47.5 卤5.6% (48.2 卤4.5%). Left atrial appendage ejection fractionation (LAA-EFL). [17.1 卤2.7 卤17.5 卤1.9%, maximum left atrial appendage emptying velocity. [Left atrial appendage emptying maxiumun speed LAA-PEV], left ventricular ejection fraction. [Left ventricular ejection fractionation (LVEF). [59 卤1. 7% and 59. 1 卤2. 2% of BNP in blood. [46.2 卤8.4 ng / L] hs-CRP. [There was no significant difference between 8.54 卤2.21 mg / L and 7.91 卤3.1 mg / L; More than one year after treatment, the above indexes were improved in both groups, and LAD in radiofrequency ablation group was improved. [Lavmax 35.6 卤3.4 mm. [6. 5 卤4. 4mL] Levi. [72.6 卤5.4 m L / m 2] LAAVmax. [4. 1 卤0. 5 mL and blood BNP. [17.8 卤5.3 ng / L] hs-CRP. [4.23 卤1.6 mg / L was lower than that in conservative treatment group. [39.2 卤2.1 m ~ (-1) m ~ (-1) + 72.7 卤3.1 m ~ (-1) m ~ (-1) Li ~ (89.4 卤2.7) m ~ (-1) 路m ~ (2) ~ (-1) ~ (4) 卤0.6 ~ (-1) m ~ (-1). 30.1 卤6.3 ng / L = 5.5 卤2.2 mg / L] LAA-PEV. [38.1 卤6.5 cm / s] LAA-EF. [Lef 22.2 卤3.5%. [55.6 卤5.3%] LVEF. [65 卤1.4%] was higher than that in conservative treatment group. [33.6 卤7.3 cm / s / s = 20.2 卤3.1% and 51.1 卤5.7%, 60.1 卤1.1% respectively. Conclusion radiofrequency catheter ablation can reverse the structure and function of left atrium and left atrial appendage in patients with NRAF.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.75
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