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[1]王爱芬,崔利军,马向红.非瓣膜性心房颤动左心房/左心耳血栓形成的相关因素分析[J].天津医科大学学报,2015,21(02):130-133.
 WANG Ai-fen,CUI Li-jun,MA Xiang-hong.Related factors of left atrial or left atrial appendage thrombus formation in patients with non-valvular atrial fibrillation[J].Journal of Tianjin Medical University,2015,21(02):130-133.
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
21卷
期数:
2015年02期
页码:
130-133
栏目:
临床医学
出版日期:
2015-03-20

文章信息/Info

Title:
Related factors of left atrial or left atrial appendage thrombus formation in  patients with non-valvular atrial fibrillation
文章编号:
1006-8147(2015)02-0130-04
作者:
王爱芬崔利军马向红
(天津医科大学第二医院心脏科,天津 300211)
Author(s):
WANG Ai-fen CUI Li-jun MA Xiang-hong
(Department of Caridiology,The Second Hospital, Tianjin Medical University, Tianjin 300211, China)
关键词:
心房颤动经食管心脏超声CHADS2评分左心房血栓左心耳血栓
Keywords:
atrial fibrillation transesophagel echocardiography CHADS2 score left atrial thrombus left atrial appendage thrombus
分类号:
R541.7
DOI:
-
文献标志码:
A
摘要:
目的:探讨非瓣膜性心房颤动(房颤)患者左心房(LA)/左心耳(LAA)血栓形成的相关危险因素。方法:连续纳入行经食道心脏超声检查的非瓣膜性房颤患者204例,删除不符合条件的11例,分为血栓组22例和非血栓组171例。详细记录患者既往病史、实验室检验结果、经胸心脏彩超及经食管心脏超声(TEE)结果,根据患者一般资料,计算其CHADS2评分,比较两组资料的差别,多因素Logistic回归分析探讨LA/LAA血栓形成的危险因素。结果:(1)入选的193例患者中男116例、女77例,平均年龄 (61.38±9.58) 岁,阵发性房颤150例(77.9%),持续性/永久性房颤43例 ( 22.1%),经3D食道超声心动图检查确诊LA/LAA血栓22例(11.4%),非血栓组171例(88.6%)。(2)两组患者年龄、BMI、饮酒史、高血压病、糖尿病、冠心病、脑卒中/TIA病史、房颤病程差异均无统计学意义(P>0.05)。血栓组男性、吸烟史、持续性/永久性房颤、左房云雾影比例、左房内径(LAD)、尿酸(UA)水平明显高于对照组(P<0.05);两组CHADS2评分无明显差异(P>0.05)。(3)多因素Logistic回归分析显示,LAD(OR=1.115,95%CI: 1.011~1.011,P=0.029)、持续性/永久性房颤(OR=0.319,95%CI: 0.108~0.938,P=0.038)及左房云雾影(OR=0.200,95%CI: 0.066~0.602,P=0.004)是LA/LAA血栓形成的独立危险因素。结论:LAD扩大、持续性/永久性房颤及左房云雾影是LA/LAA血栓形成的高危因素。
Abstract:

Objective: To investigate risk factors to predict left atrial or left atrial appendage thrombus in non-valvular atrial fibrillation patients. Methods: The study was a retrospective cohort study in which 204 consecutive non-valvular AF patients were enrolled, 11 patients in mismatch condition were abandoned, and all patients were divided into LA/LAA thrombus group(n=22)and non LA/LAA thrombus group(n=191). Patients’ medical history, general conditions, laboratory test results, transthoracic echocardiography(TTE) and transesophagel echocardiography(TEE) results were recorded in detail, and then CHADS2 score was calculated. Results:(1)One hundred and ninety three patients were enrolled, male 116 cases, female 77 cases, with an average age of (61.38 ± 9.58) years. Paroxysmal atrial fibrillation(AF) 150 cases (77.9%), persistent / permanent AF 43 cases (22.1% ), the LA/LAA thrombus confirmed by 3D transesophageal echocardiography were 22 cases (11.4%), non-thrombotic group 171 cases (88.6%). (2) No significant differences were found between two groups at age, BMI, drinking history, hypertension, diabetes mellitus, stroke or TIA, course of AF(P>0.05). The proportion of male, smoking history, persistent and permanent AF, left atrial spontaneous echo contrast(SEC), left atrial diameter (LAD), uric acid (UA) levels were significantly higher in thrombosis group(P<0.05).However,the CHADS2 score had no significant difference between two groups(P>0.05). (3)Multivariate Logistic regression analysis demonstrated that LAD(OR=1.115,95%CI: 1.011~1.011,P=0.029), persistent and permanent AF(OR=0.319,95%CI: 0.108~0.938,P=0.038), SEC(OR=0.200,95%CI: 0.066~0.602,P=0.004)were independent risk factors for LA/LAA thrombus. Conclusion: LAD expansion, persistent and permanent AF and SEC are high-risk factors for LA / LAA thrombus formation.

 

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备注/Memo

备注/Memo:
作者简介 王爱芬(1975-),女,主治医师,硕士在读,研究方向:冠心病,心律失常等;通信作者:马向红,E-mail: ma_xianghong@163.com
更新日期/Last Update: 2015-03-24