心房颤动患者左心房血栓形成的危险因素探讨

发布时间：2018-05-30 19:52

本文选题：心房动颤 + 左心房血栓　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的:探讨心房颤动患者左心房血栓形成的危险因素。方法:收集资料完整的2009年01月-2014年10月在我院住院并行心房颤动射频消融的心房颤动患者113例,其中男性75例,女性38例;分为左心房血栓组16例和无血栓组97例。收集患者的年龄、性别、既往病史(高血压、糖尿病、冠心病),凝血功能相关指标(FIB、INR);所有患者均行经食道心脏彩色超声,收集心脏彩超数据(左房内径、左室舒末径、EF值);心脏CT检查(心脏CT心房三维重建),将左心耳形态分为仙人掌型、鸡翅型、菜花型、风向袋型;结果:113例心房颤动患者中左心房血栓者16例,发生率14.16%,两组患者在病程、心房颤动分类、高血压、冠心病、左室舒末径、EF值、FIB、INR方面比较均无统计学差异(均P0.05)。女性患者左心房血栓发生率(33.68%)较男性高(9.33%),P0.05;血栓组年龄(62.31±6.457岁)较无血栓组(53.81±11.225岁)大,P0.01;血栓组中糖尿病所占比例(25%)较无血栓组(6.2%)高,P0.05;血栓组左房内径(42.88±6.888mm)较无血栓组(37.21±6.185)大,P0.01;菜花型左心耳患者左心房血栓阳性率(30.77%)较其他类型高,P0.05;Logistic回归结果示年龄(OR=1.124,P=0.041)、糖尿病(OR=16.803,P=0.013)、左房内径(OR=1.121,P=0.048)是心房颤动患者左心房血栓形成的危险因素。结论:心房颤动患者左心房血栓形成的危险因素有年龄、性别(女性)、糖尿病、左房内径、左心耳解剖形态,其中年龄、糖尿病、左房内径是左心房血栓形成的独立危险因素。
[Abstract]:Objective: to investigate the risk factors of left atrial thrombosis in patients with atrial fibrillation. Methods: from January 2009 to October 2014, 113 patients with atrial fibrillation underwent radiofrequency ablation of atrial fibrillation, including 75 males and 38 females, were divided into left atrial thrombus group (n = 16) and non-thrombotic group (n = 97). Age, sex, past medical history (hypertension, diabetes, coronary heart disease, coagulation function related indexes) were collected. All patients underwent transesophageal echocardiography and collected echocardiographic data (left atrial diameter, left atrial diameter). Left ventricular diastolic diameter and EF value, cardiac CT scan (cardiac CT atrial three-dimensional reconstruction, left atrial auricular shape divided into cactus type, chicken wing type, cauliflower type, wind bag type, results of 113 patients with atrial fibrillation in 16 cases, left atrial thrombosis, The incidence rate was 14.16%. There was no significant difference in course of disease, classification of atrial fibrillation, hypertension, coronary heart disease, EF value of left ventricular diastolic diameter and FIBN INR between the two groups (all P 0.05). The incidence of left atrial thrombus in female patients (33.68%) was higher than that in men (P 0.05; the thrombus group was 62.31 卤6.457 years old); the thrombus group was 53.81 卤11.225 years old; the proportion of diabetes mellitus in the thrombus group was 25.5% higher than that in the non-thrombus group (P 0.05); the left atrial diameter in the thrombus group was 42.88 卤6.888mm) and the left atrial diameter was 37.21 卤6.185 mm in the thrombus group. The positive rate of left atrial thrombus in the patients with cauliflower type of left atrial appendage was 30.777.The logistic regression analysis showed that the risk factors of left atrial thrombosis in patients with atrial fibrillation were as follows: age = 1.124P = 0.041, DM = 16.803 / P 0.013, left atrial diameter = 1.121P 0.048). Conclusion: the risk factors of left atrial thrombosis in patients with atrial fibrillation are age, sex (female, diabetes, left atrial diameter, left atrial appendage anatomy, age, diabetes, left atrial diameter are independent risk factors of left atrial thrombosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.75

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