非瓣膜性房颤经食道超声心动图的研究

目的探讨TEE检测非瓣膜性房颤左心耳的大小及功能与左心耳内血栓形成之间的关系,为临床进行风险评估、判断愈后及指导治疗等方面提供重要依据。方法采用TEE对41例非瓣膜性房颤伴有或不伴有高血压患者进行左心耳检测,根据左心耳的形态特点,测量出左心耳入口的宽度、左心耳顶部到入口的长度,同样用描记法测出左心耳舒张末容积,运用脉冲多普勒测出左心耳血流充盈与排空速度,检测左心耳内透声情况及有无血栓。结果41例房颤患者中左心耳血栓7例,有血栓组与无血栓组的左心耳的大小、容积无显著性差异,而左心耳的峰值血流排空速度差异具有显著性;随房颤病程变化,左心耳容积具有显著性差异(P<0.05);房颤伴高血压组与不伴高血压组上述指标亦具有显著性差异。结论左心耳大小、形态的改变,功能的减低,血流速度的减慢是房颤患者左心耳内血栓形成的重要危险因素。因此,对左心耳大小、形态及功能的检测可以帮助临床进行风险评估、判断愈后以及指导治疗等方面都有着重要的临床价值。

The Study of the Function and Thrombus of Left Atrium Appendage in Patients with Nonvalvalar Atrial Fibrillation by Transesophageal Echocardiography

Objective To explore the correlation between the shape and function of left atrium appendage(LAA) and thrombus formation in patients with atrial fibrillation(Af) by transesophageal echocardiography(TEE).Methods The length,diameter,volume,peaking ejection velocity(Pev) were measured with TEE in patients with Af,and detected the thrombus or not in LAA.Results 7 patients had thrombus in LAA.All patients with Af were divided into 6 groups according to with or without Hypertension or Thrombus and duration of history,Compared with control group,every indice has satistically significantly in all patients with Af,all indices had satistically significantly(P<0.05) in patients between with and without hypertension.The Volume of LAA in patients that Af history is more than 5 years had satistically significantly(P<0.05).The Pev and ejection fraction(Ef) of LAA had satistically significantly in patients between with and without thrombus(P<0.05).Conclusion The thrombus formation is relation to the dilation,dysfunction and lower peak of flow velocity of LAA.The assessment of function LAA in patients with Af by TEE can help to indentify the risk of thrombus formation and guid optimal treatment.