年龄对非瓣膜病心房颤动患者左心房血栓的影响

目的评价年龄对非瓣膜病心房颤动(房颤)患者左心房血栓的影响。方法选择拟行导管射频消融完成经食管超声检查的房颤患者421例,根据年龄分为老年组(108例)和年轻组(313例)。根据是否存在左心房血栓又分为血栓组(26例)和无血栓组(395例)。各组间进行一般临床资料比较。结果老年组年龄、高血压、服用血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)的比例明显高于年轻组,非阵发性房颤的比例明显低于年轻组。老年组LVEF明显高于年轻组。血栓组非阵发性房颤、心力衰竭、栓塞史、服用ACEI/ARB的比例明显高于无血栓组。血栓组左心房直径明显大于无血栓组,LVEF明显低于无血栓组。logistic多因素分析显示,校正LVEF、心力衰竭、高血压、糖尿病、服用ACEI/ARB,左心房直径、非阵发性房颤、既往栓塞史是左心房血栓独立预测因素,老年不是左心房血栓独立危险因素。结论年龄不是非瓣膜病房颤患者心房血栓的预测因素。

Impact of age on the left atrial thrombus in patients with non-valvular atrial fibrillation

Objective To investigate the impact of age on left atrial thrombus in patients with non-valvular atrial fibrillation(AF).Methods Four hundred and twenty-one consecutive patients with AF who planned to undergo transesophageal echocardiography prior to AF ablation were included. The patients were divided into the elderly group (n = 108) and the young group (n= 313). The patients were also divided into the thrombus group (n= 26) and the non-thrombus group (n = 395).Results The proportions of males,hypertension,ACEI/ARB medication were significantly higher in the elderly group.The proportion of non-paroxysmal AF was lower in the elderly group than in the young group.The left ventricular ejection fraction was significantly higher in the elderly group.The proportions of non-paroxysmal AF,heart failure,thromboembolic events, ACEI/ARB medication were significantly higher in the patients with left atrial thrombus (P < 0.05,P< 0.01).The left atrium size was larger,the left ventricular ejection fraction was lower in the thrombus group than in the non-thrombus group (P <0.01).After adjustment for ejection fraction,heart failure,hypertension,diabetes mellitu and ACEI/ARB medication in logistic multivariate analysis,left atrium diameter,non-paroxysmal AF,prior thromboembolic history were independent risk factors for left atrium thrombus.However,age was not an independent risk factor for left atrial thrombus.Conclusions Age itself was not a risk factor for left atrial thrombus in patients with non-valvular AF.