| 杨 杨,申晓彧,岳云飞,李 佳,王玉玲.左心耳血流速度联合血清D-D、TBIL预测非瓣膜性心房颤动患者左心耳血栓形成的临床研究[J].,2024,(15):2920-2924 |
| 左心耳血流速度联合血清D-D、TBIL预测非瓣膜性心房颤动患者左心耳血栓形成的临床研究 |
| Clinical Study of Left Atrial Appendage Blood Flow Velocity Combined with Serum D-D and TBIL in Predicting Left Atrial Appendage Thrombosis in Patients with Non-Valvular Atrial Fibrillation |
| 投稿时间：2024-01-30 修订日期：2024-02-26 |
| DOI：10.13241/j.cnki.pmb.2024.15.022 |
| 中文关键词: 非瓣膜性心房颤动 左心耳 血栓形成 血流速度 D-二聚体 总胆红素 |
| 英文关键词: Non-valvular atrial fibrillation Left atrial appendage Thrombosis Blood flow velocity D-dimer Total bilirubin |
| 基金项目:山西省重点研发计划项目（201903D421071） |
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| 中文摘要: |
| 摘要 目的：评估左心耳（LAA）血流速度联合血清D-二聚体（D-D）、总胆红素（TBIL）在非瓣膜性心房颤动（NVAF）患者LAA血栓形成中的预测价值。方法：选择2020年7月至2022年10月就诊于山西医科大学第二医院的340例NVAF患者，按照有无LAA血栓形成结果分为血栓组（52例）、无血栓组（288例）。对比两组基线资料、LAA血流速度、D-D、TBIL水平。采用多因素logistic回归模型分析影响NVAF患者LAA血栓形成的因素，受试者工作特征（ROC）曲线分析LAA血流速度联合血清D-D、TBIL预测NVAF患者LAA血栓形成的价值。结果：血栓组持续性房颤比例、年龄、B型钠尿肽（BNP）、D-D、TBIL水平高于无血栓组（P＜0.05）；血栓组LAA充盈速度、LAA排空速度低于无血栓组（P＜0.05）。经多因素Logistic回归分析发现，持续性房颤、年龄大、BNP水平升高、D-D水平升高、TBIL水平升高是影响NVAF患者LAA血栓形成的危险因素（P＜0.05），LAA充盈速度高、LAA排空速度高是保护因素（P＜0.05）。ROC曲线分析发现，LAA充盈速度、LAA排空速度、D-D、TBIL及四者联合预测NVAF患者LAA血栓形成的AUC为0.826、0.735、0.833、0.837、0.928，其中四者联合预测的AUC显著高于单一预测。结论：LAA充盈速度降低、LAA排空速度降低、D-D水平上升、TBIL水平上升是NVAF患者LAA血栓形成的影响因素。LAA血流速度联合D-D、TBIL可提升NVAF患者LAA血栓形成的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the predictive value of left atrial appendage (LAA) blood flow velocity combined with serum D-dimer (D-D) and total bilirubin (TBIL) in LAA thrombosis in patients with non-valvular atrial fibrillation (NVAF). Methods: 340 patients with NVAF who were admitted to The Second Hospital of Shanxi Medical University from July 2020 to October 2022 were selected and divided into thrombus group (52 cases) and non thrombus group (288 cases) according to the presence or absence of LAA thrombosis. The baseline data, LAA blood flow velocity, D-D and TBIL levels were compared between two groups. The factors affecting LAA thrombosis in NVAF patients were analyzed by multivariate logistic regression model, the value of LAA blood flow velocity combined with serum D-D and TBIL in predicting LAA thrombosis in NVAF patients were analyzed by receiver operating characteristic (ROC) curve. Results: The proportion of persistent atrial fibrillation, age, B-type natriuretic peptide (BNP), D-D and TBIL levels in thrombus group were higher than those in non thrombus group (P<0.05). The LAA filling speed and LAA emptying speed in thrombus group were lower than those in non thrombus group (P<0.05). Multivariate logistic regression analysis showed that, persistent atrial fibrillation, older age, increased BNP level, increased D-D level, and increased TBIL level were risk factors for LAA thrombosis in NVAF patients (P<0.05), high LAA filling speed and high LAA emptying speed were protective factors (P<0.05). ROC curve analysis showed that the AUC (95 % CI) of LAA filling speed, LAA emptying speed, D-D, TBIL and the combination of the four in predicting LAA thrombosis in NVAF patients was 0.826 (0.764-0.888), 0.735 (0.668-0.802), 0.833 (0.763-0.903), 0.837 (0.777-0.897), 0.928 (0.887-0.970), and the AUC of the combination of the four was significantly higher than that of the single prediction. Conclusion: The decrease of LAA filling speed, the decrease of LAA emptying speed, the increase of D-D level and the increase of TBIL level are the influencing factors of LAA thrombosis in NVAF patients. LAA blood flow velocity combined with D-D and TBIL can improve the predictive value of LAA thrombosis in NVAF patients. |
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