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非瓣膜性房颤患者左心房结构与左心耳自发显影、<br />左心耳血栓的相关性研究

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摘要:

目的 探索非瓣膜性房颤(NVAF)患者左心房(LA)结构指标与左心耳自发显影
(LAASEC)、左心耳血栓(LAAT)的相关性。方法 收集2016年3月1日至2019年12月31日于西安交通
大学第一附属医院心内科住院的NVAF患者,以经食道超声(TEE)所示左心耳(LAA)情况分为:血栓
组42例、自发显影(SEC)组69例和对照组(无LAASEC或LAAT)273例。分析NVAF患者的LA结构指标
与LAASEC、LAAT的相关性。结果 LAA开口径(OR=1.208,95%CI:1.094~1.333,P<0.001),LAA血
流速度<40 cm/s(OR=72.329,95%CI:24.065~217.392,P<0.001)、LA左右径(OR=1.037,95%CI:
1.010~1.065,P=0.008)、LA上下径(OR=1.071,95%CI:1.029-1.116,P=0.001)、RSPV与RIPV间距
(OR=1.089,95%CI:1.019~1.163,P=0.012)、RSPV与LSPV间距(OR=1.034,95%CI:1.004~1.066,
P=0.027)均是LAASEC的独立危险因素;LAA血流速度<40 cm/s(OR=15.268,95%CI:6.652~35.045,
P<0.001)是LAAT的独立危险因素。结论 临床中应对有上述危险因素的NVAF患者重点关注,及早干
预,以减少脑卒中的发生。

Abstract:

Objective To investigate the relationship among left atrial structure indexes, left atrial appendage
spontaneous echo contrast (LAASEC) and left atrial appendage thrombus (LAAT) in patients with non-valvular atrial
fibrillation (NVAF). Methods NVAF patients were chosen from Department of Cardiology in the First Affiliated
Hospital of Xi`an Jiaotong University from Mar. 1, 2016 to Dec. 31, 2019. All patients were divided, according to
the status of left atrial appendage (LAA) shown by transesophageal echocardiography (TEE), into thrombus group
(n=42), spontaneous echo contrast group (SEC group, n=69) and control group (no LAASEC or no LAAT, n=273).
The left atrial structure indexes, and correlation among them and LAASEC and LAAT were analyzed. Results
LAA open caliber (OR=1.208, 95%CI: 1.094~1.333, P<0.001), LAA flow velocity<40 cm/s (OR=72.329, 95%CI:
24.065~217.392, P<0.001), left atrial mediolateral diameter (OR=1.037, 95%CI: 1.010~1.065, P=0.008), left atrial
suproinferior diameter (OR=1.071, 95%CI: 1.029~1.116, P=0.001), the interval between right superior pulmonary
vein (RSPV) and right inferior pulmonary vein (RIPV, OR=1.089, 95%CI: 1.019~1.163, P=0.012), and interval
between RSPV and left superior pulmonary vein (LSPV, OR=1.034, 95%CI: 1.004~1.066, P=0.027) all were
independent risk factors of LAASEC. LAA flow velocity<40 cm/s (OR=15.268, 95%CI: 6.652~35.045, P<0.001)
was an independent risk factor of LAAT. Conclusion In clinical practice, more attention should be paid to NVAF
patients with the above risk factors, and early intervene will reduce stroke incidence.

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