风湿性二尖瓣狭窄左房血栓形成的超声心动图分析

目的　通过超声心动图检查结果回顾性分析探讨风湿性二尖瓣狭窄左房血栓形成的相关因素。方法　对 10 5例风湿性二狭患者行经胸及经食管超声心动图检查 ,根据左房和 /或左心耳内有无血栓形成进行分组。结果　有血栓组与无血栓组相比 ,在年龄、性别、左房大小方面无明显差异。血栓形成组心房纤颤及左房自发显影发生率高 ,二尖瓣口面积较小且无明显二尖瓣返流。多元回归分析表明心房纤颤、左房自发显影、二尖瓣口面积是左房血栓形成的独立相关因素。结论　风湿性二狭患者 ,尤其在没有二尖瓣返流且合并心房纤颤、左房自发显影时 ,发生左房血栓的风险性较高。

The echocardiography analysis of left atrial thrombusis in patient with rheumatic mitral stenosis

Objective To analyse the related factors of left atrial thrombosis in patients with rheumatic mitral stenosis by echocardiography. Methods The transthoracic and transesophageal echocardiograms were peformed in 105 patients with rheumatic mitral stenosis. According to left atrium and/or left atrial appendage having thrombus or having nothrombus, all the patients were divided into two groups. Results There was no significant difference between patients who had thrombus and those who had no thrombus in age, sex and the diameter of left atrium. Patients with thrombus had a higher incidence of atrial fibrillalion(Af)and left atrial spontaneous echo contrast(SEC),and had smaller mitral valve area(MVA)and no significant mitral regurgitation. Logistic regression analysis showed that Af, left atrial SEC and MVA were independent predictors of left atrial thrombusis. Conclusion Patients with rheumatic mitral stenosis are at high risk of left atrial thrombosis,especially in those who had no mitral regurgitation but had Af and left atrial SEC.