摘要
目的:研究经胸超声心动图(TTE)、经食管超声心动图(TEE)及血清学指标预测房颤患者左心耳血栓的临床价值。方法:纳入2020年5月~2021年4月于我院收治的85例房颤患者为研究对象,根据患者是否合并有左心耳血栓将患者分为单纯房颤组(n=76)和房颤合并左心耳血栓组(n=9)。患者均行经胸超声心动图及经食管超声心动图检查,分别获得检查参数包括心脏收缩期的左房前后径(LAD)、心脏舒张末期的左室前后径(LVDD)、左心房射分数(LAEF)、舒张早期二尖瓣口血流速度峰值/二尖瓣环根部侧壁运动速度峰值比值(E/Ea)和左心耳射血分数(LAAEF)、左心耳口宽度(LAA-D)、左心耳长度(LAA-L)、左心耳最大排空速度(LAA-PEV)、左心耳最大充盈速度(LAA-PFV)。并检测两组血清学指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)、肌酸激酶同功酶(CK-MB)、脑钠肽(BNP)],分析房颤合并左心耳血栓的影响因素。结果:房颤合并左心耳血栓组D-D水平均显著高于单纯房颤组。房颤合并左心耳血栓组LAD、E/Ea均显著高于单纯房颤组。房颤合并左心耳血栓组LAAEF、LAA-PFV均显著低于单纯房颤组。多因素Logistic回归分析显示,D-D、LAD、E/Ea、LAAEF、LAA-PFV是房颤合并左心耳血栓的独立影响因素。结论:TEE为诊断左心耳血栓的金标准,TTE及D-D水平可作为早期预测房颤合并左心耳血栓的有效手段。
Objective To study the clinical value of transthoracic echocardiography(TTE),transesophageal echocardiography(TEE)and serum markers in predicting left atrial appendage thrombosis in patients with atrial fibrillation.Methods 85 patients with atrial fibrillation admitted to our hospital from May 2020 to April 2021 were selected as the research objects.According to whether the patients had left atrial appendage thrombosis,the patients were divided into simple atrial fibrillation group(n=76)and atrial fibrillation combined with left atrial appendage thrombosis group(n=9).All patients were examined by transthoracic echocardiography and transesophageal echocardiography.The parameters included systolic left atrial anteroposterior diameter(LAD),end diastolic left ventricular anteroposterior diameter(LVDD),left atrial ejection fraction(LAEF),left atrial ejection fraction(LVEF),left atrial ejection fraction,ratio of peak velocity of mitral orifice to peak velocity of mitral annular root wall in early diastole(E/EA),left atrial appendage ejection fraction(laaef),the width of left auricular opening(laa-d),the length of left atrial ear(laa-l),the maximum emptying velocity of left atrial ear(LAA PEV)and the maximum filling velocity of left atrial ear(LAA PFV)were observed,the serum indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),D-Dimer(D-D),creatine kinase isoenzyme(CK-MB),brain natriuretic peptide(BNP)]of the two groups were detected,and the influencing factors of atrial fibrillation complicated with left atrial appendage thrombosis were analyzed.Results The levels of D-D in atrial fibrillation combined with left atrial appendage thrombosis group were significantly higher than those in simple atrial fibrillation group.Lad and E/EA were significantly higher in atrial fibrillation combined with left atrial appendage thrombosis group than in atrial fibrillation group.Laaef and laa-pfv in AF with LAA thrombus group were significantly lower than those in AF group.Multivariate logistic regression analysis showed that D-D,lad,E/EA,laaef,laa-pfv were the independent influencing factors of atrial fibrillation complicated with left atrial appendage thrombosis.Conclusion TEE is the gold standard for the diagnosis of left atrial appendage thrombosis.TTE and D-D levels can be used as an effective means for early prediction of atrial fibrillation complicated with left atrial appendage thrombosis.
作者
陈曦
丁中
杨晓双
王艳昕
Chen Xi;Ding Zhong;Yang Xiao-shuang;Wang Yan-xin(Department of Ultrasound,The Third People’s Hospital of Bengbu City,Bengbu 233000,China;Department of Laboratory Medicine,The Third People’s Hospital of Bengbu City,Bengbu 233000,China;Department of Cardiology,The Third People’s Hospital of Bengbu City,Bengbu 233000,China)
出处
《湖南师范大学学报（医学版）》
2021年第4期187-190,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
经食管超声心动图
经胸超声心动图
房颤
左心耳血栓
transesophageal echocardiography
transthoracic echocardiography
atrial fibrillation
thrombus of left atrial eara
作者简介
通讯作者:陈曦,E-mail:1170644746@qq.com
