| 崔 蕾,雒 尧,何 艳,程莉莉,许岭平.经食道超声心动图评估特发性房颤左心房左心耳的价值[J].现代生物医学进展英文版,2017,17(10):1903-1906. |
| 经食道超声心动图评估特发性房颤左心房左心耳的价值 |
| The Value of Transesophageal Echocardiography in Evaluation of Left Atrial and Left Atrial Appendage in Patients with Idiopathic Atrial Fibrillation |
| Received:August 15, 2016 Revised:September 12, 2016 |
| DOI：10.13241/j.cnki.pmb.2017.10.027 |
| 中文关键词: 经食道超声心动图 特发性房颤 左心房 左心耳 临床价值 |
| 英文关键词: Transesophageal echocardiography Idiopathic atrial fibrillation Left atrial Left atrial appendage Clinical value |
| 基金项目: |
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| 中文摘要: |
| 摘要 目的：研究经食道超声心动图（TEE）评估特发性房颤左心房左心耳的临床价值。方法：选择自2015年1月到2016年8月在医院接受诊治的特发性房颤患者100例纳入本次研究，阵发性房颤92例，记为阵发性房颤组；持续性房颤8例，记为持续性房颤组。另选同期在医院进行健康体检的心功能正常志愿者90例作为对照组。利用TEE对受试者进行检查，对比房颤组与对照组的左心房及左心耳参数，是否含有自发性显影（LASEC）的房颤患者的左心房及左心耳参数，利用TEE分析对房颤患者的预后情况。结果：阵发性房颤组左心房的前后径和左右径，左心耳血流最大的排空速度（Lev）均明显小于对照组，左心耳的面积变化率及最大的充盈速度（Lfv）均明显大于对照组，差异有统计学意义（P＜0.05）。持续性房颤组左心房的前后径和左右径均明显大于对照组，左心耳的面积变化率、Lev及Lfv均明显小于对照组，差异有统计学意义（P＜0.05）。阵发性房颤组左心房的前后径和左右径均明显小于持续性房颤组，左心耳的面积变化率、Lev及Lfv均明显大于持续性房颤组，差异有统计学意义（P＜0.05）。有LASEC者左心房的前后径和左右径均明显大于无LASEC者，左心耳的面积变化率、Lev及Lfv均明显小于无LASEC者，差异有统计学意义（P＜0.05）。100例房颤患者中发现34例LASEC，占34.00%，其中有18例患者合并有左心耳血栓，占18.00%。总计有66例患者接受导管射频消融疗法，占66.00%，均未在术中及术后7d内出现血栓及栓塞并发症。结论：利用TEE对特发性房颤的患者左心房及左心耳进行评估，有利于更好的辅助患者的临床治疗，值得重视。 |
| 英文摘要: |
| ABSTRACT Objective: To study the clinical value of transesophageal echocardiography(TEE) in evaluation of left atrial and left atrial appendage in patients with idiopathic atrial fibrillation. Methods: 100 patients with idiopathic atrial fibrillation were enrolled in this study in the hospital from January 2015 to August 2016, among with 92 patients with paroxysmal atrial fibrillation was recorded as paroxysmal atrial fibrillation group, and 8 patients with persistent atrial fibrillation was recorded as persistent atrial fibrillation group.Selected 90 cases of healthy heart function normal volunteers as control group in the hospital in the same period, all subjects were examined by TEE. Compared the left atrium and left atrial appendage parameters in idiopathic atrial fibrillation group and the control group, and compared the left atrial and left atrial appendage parameters in patients with or without left atrial spontaneous echocardiographic contrast(LASEC), and analyzed the prognosis in patients with atrial fibrillation. Results: The front-back diameter and left-right diameter, left atrial Lev in paroxysmal atrial fibrillation group were significantly lower than the control group, the area change rate of the left atrial appendage and Lfv were significantly higher than the control group, the difference was statistically significant(P<0.05). The front-back diameter and left-right diameter in persistent atrial fibrillation group were significantly larger than those of the control group, the area change rate of the left atrial appendage, Lev and Lfv were significantly lower than the control group, the difference was statistically significant(P<0.05). The front-back diameter and left-right diameter in the paroxysmal atrial fibrillation group were significantly less than the persistent atrial fibrillation group, the area change rate of the left atrial appendage, Lev and Lfv were significantly higher than persistent atrial fibrillation group,the difference was statistically significant(P<0.05). The front-back diameter and left-right diameter of patients with left atrial spontaneous echocardiographic contrast(LASEC)were significantly larger than without LASEC, while the area change rate of the left atrial appendage, Lev and Lfv were significantly lower than without LASEC, the difference was statistically significant(P<0.05). 34 cases of patients with LASEC were found in 100 patients with atrial fibrillation, accounting for 34.00%, of which 18 cases of patients with left atrial thrombus, accounting for 18.00%. A total of 66 patients received catheter ablation therapy, accounting for 66.00%, who did not occur thrombosis and embolism complications in the intraoperative and 7 d after treatment. Conclusion: Using TEE to evaluate the left atrial and left atrial appendage of patients with idiopathic atrial fibrillation is helpful to assist the clinical treatment, which is worthy of attention. |
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