| 实时三维经食管超声心动图评价心房颤动患者左心耳的容积和功能改变 |
| 投稿时间：2017-08-16 修订日期：2017-09-13 点此下载全文 |
| 引用本文：吴庆,吴道珠,刘咏芳,倪贤伟.实时三维经食管超声心动图评价心房颤动患者左心耳的容积和功能改变[J].医学研究杂志,2018,47(5):174-178,93 |
| DOI：
10.11969/j.issn.1673-548X.2018.05.042 |
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| 中文摘要:目的 应用实时三维经食管超声心动图（RT3D-TEE）评价非瓣膜性心房颤动（以下简称房颤）患者左心耳的容积和功能改变。方法 选取55例笔者医院准备接受射频消融治疗的房颤患者作为病例组，根据是否合并高血压将病例组分为高血压房颤组和孤立性房颤组，应用经胸超声心动图及RT3D-TEE观察左心房及左心耳内有无自发显影（SEC）和血栓，同时获取左心耳相关参数，并对各组中左心耳参数进行比较。结果 所有患者中共有15例出现LA及LAA自发显影，其中孤立性房颤组占5例，高血压房颤组占10例且2例伴血栓形成。与正常对照组比较，房颤组患者LAD、ML、MA、EDV及ESV均增大，而PEV和EF减小，且差异有统计学意义（P<0.05）。而在病例组中，高血压房颤组与孤立性房颤组比较，上述参数中MA、EDV、EF及PEV差异有统计学意义（P<0.05），LAD、ML、ESV差异无统计学意义（P>0.05）。与正常对照组比较，SEC组患者，LAD、MA、ML、EDV、ESV均增大，而PEV和EF减小，且差异有统计学意义（P<0.05）。结论 应用RT 3D-TEE定量分析左心耳容积参数及功能的改变是可行的。不论是否合并高血压，房颤患者左心耳功能均较正常人减低，合并高血压时左心耳功能的减低更明显。 |
| 中文关键词:心房颤动 左心耳 实时三维 经食管超声 高血压 |
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| Assessment of the Volume and the Function of Left Atrial Appendage in Patient with Atrial Fibrillation by Using Real-time Three-dimensional Transesophageal Echocardiography |
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| Abstract:Objective To evaluate the volume and the function of left atrial appendage in patient with nonvalvular atrial fibrillation by using real-time three-dimensional transesophageal echocardiography (RT3D-TEE).Methods Fifty-five consecutive patients who were candidates for catheter ablation for AF were selected as case group and were divided into hypertensive atrial fibrillation(HAF) group and lone atrial fibrillation(LAF) group. Using TTE and RT3D-TEE,we observed whether there was spontaneous echo contrast (SEC) and thrombosis in the left atrium(LA) and left atrial appendage(LAA), and to obtain the relative date of left atrial appendage volume and function. Then the dates were compared between each group.Results There were fifteen cases of LA and LAA SEC, of which five cases of isolated atrial fibrillation group, ten cases of hypertensive atrial fibrillation group and two cases of thrombosis. Compared with the normal control group, the LAD,MD, MA, EDV and ESV increased in patients with atrial fibrillation(AF), while PEV and EF decreased, and the difference was statistically significant (P<0.05). However, in patients with atrial fibrillation, the difference of MA, EDV, EF and PEV was statistically significant (P<0.05), and there were no significants differences in LAD, MD and ESV between HAF group and LAF group. Compared with the normal control group, in SEC group,MA, MD, EDV, ESV increased, while PEV and EF decreased, and the difference was statistically significant (LAD).Conclusion Using RT3D-TEE to identify the formation of thrombus and quantitatively analyze the volume and function of LAA is feasible. No matter whether combining hypertension, LAA function in patients with atrial fibrillation (AF) were decreased, and LAA function become worse when combined hypertension. |
| keywords:Atrial fibrillation Left atrial appendage Real-time three-dimensional Transesophageal echocardiography Hypertension |
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