风湿性二尖瓣狭窄左心房血栓形成的危险因素分析

目的 探讨风湿性二尖瓣狭窄左心房血栓形成的危险因素.方法 2001年1月至2008年12月,2277例风湿性二尖瓣狭窄病人接受手术治疗,男737例,女1540例;年龄19～84岁,平均(50.9±10.2)岁.按左心房有无血栓分为血栓组(554例)和无血栓组(1723例).回顾性分析入选病例的一般资料、心电图、超声心动图及实验室检查资料.对单因素分析中有统计学意义的指标行多因素回归分析.结果 单因素分析发现年龄、二尖瓣瓣口面积、左心房内径、左室舒张末径、C反应蛋白、性别、二尖瓣狭窄程度、二尖瓣反流程度、三尖瓣反流程度、肺动脉高压程度、房颤和心功能分级共12个因素组间差异有统计学意义.多因素回归分析发现年龄、二尖瓣瓣口面积、左心房内径、二尖瓣反流程度、房颤是风湿性二尖瓣狭窄病人左心房血栓形成的主要影响因素.结论 风湿性二尖瓣狭窄病人年龄、二尖瓣瓣口面积、左心房内径、房颤是并发左心房血栓的主要危险因素.二尖瓣反流可以降低左心房血栓形成的风险,是左心房血栓形成的保护性因素.

Abstract：

Objective To analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis.Methods From January 2001 to December 2008, 2277 patients with rheumatic mitral stenosis underwent operations in our hospital. There were 737 males and 1540 female, the age ranged from 19 to 84 years [average (50.9 ±10.2) years]. Left atrial thrombosis group (554 cases) and no thrombosis group (1723 cases) were divided, retrospectively collected data were analyzed with univariate and multivariate Logistic regression. Results 12 bvariables, including age, mitral valve orifice area, left atrial diameter, left ventricular diastole diameter, CRP, gender , degree of mitral stenosis, or regurgitation, degree of bicuspid regurgitation, degree of pulmonary hypertension, atrial fibrillation and heart function had statistic difference between two groups. With multivariate Logistic regression for these 12 factors, age, mitral valve orifice area, left atrial diameter, degree of mitral regurgitation and atrial fibrillation were found to be the affecting factors for left atrial thrombosis in patients with rheumatic mitral stenosis. Conclusion For patients with rheumatic mitral stenosis, age, mitral valve orifice area, left atrial diameter and atrial fibrillation are the risk factors for left atrial thrombosis. Mitral regurgitation is a protective factor for left atrial thrombosis.

Analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis

Objective To analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis.Methods From January 2001 to December 2008, 2277 patients with rheumatic mitral stenosis underwent operations in our hospital. There were 737 males and 1540 female, the age ranged from 19 to 84 years [average (50.9 ±10.2) years]. Left atrial thrombosis group (554 cases) and no thrombosis group (1723 cases) were divided, retrospectively collected data were analyzed with univariate and multivariate Logistic regression. Results 12 bvariables, including age, mitral valve orifice area, left atrial diameter, left ventricular diastole diameter, CRP, gender , degree of mitral stenosis, or regurgitation, degree of bicuspid regurgitation, degree of pulmonary hypertension, atrial fibrillation and heart function had statistic difference between two groups. With multivariate Logistic regression for these 12 factors, age, mitral valve orifice area, left atrial diameter, degree of mitral regurgitation and atrial fibrillation were found to be the affecting factors for left atrial thrombosis in patients with rheumatic mitral stenosis. Conclusion For patients with rheumatic mitral stenosis, age, mitral valve orifice area, left atrial diameter and atrial fibrillation are the risk factors for left atrial thrombosis. Mitral regurgitation is a protective factor for left atrial thrombosis.