非瓣膜性心房颤动血栓形成的相关因素分析Prediction of left atrial thrombi in non-valvular atrial fibrillation
金彦彦,马长生,何华,刘小慧,董建增,刘兴鹏,龙德勇,喻荣辉
摘要(Abstract):
目的通过观察非瓣膜性心房颤动患者血浆C反应蛋白、D-二聚体的浓度及左心房直径、射血分数的水平,研究C反应蛋白与非瓣膜性心房颤动患者左心房内血栓形成的关系。方法按照经食管超声心动图(TEE)检查结果将非瓣膜性心房颤动患者98名分为:左心房血栓形成组(血栓组)22例、无左心房血栓形成组(非血栓组)76例。检测血浆中C反应蛋白、D-二聚体的浓度及经胸超声心动图检测左心房直径、射血分数。结果血栓组在C反应蛋白浓度、D-二聚体浓度、左心房直径、射血分数、缩短分数方面与非血栓组差异有统计学意义,分别为C反应蛋白浓度(中位数1.60mg/L比0.80 mg/L,P=0.003)、D-二聚体浓度(中位数170.50μg/L比92.00μg/L,P=0.004)、左心房直径(55.20±12.94 mm比46.77±12.31 mm,P=0.002)、射血分数(57.46%±9.10%比62.81%±8.67%,P=0.006)、缩短分数(29.82%±5.26%比35.24%±5.41%,P<0.001)。Logistic回归,发现C反应蛋白、左心房直径与非瓣膜性心房颤动合并血栓形成独立相关(P<0.05),而D-二聚体、射血分数、缩短分数与非瓣膜性心房颤动合并血栓形成无显著相关。结论CRP增高、左心房直径扩大是非瓣膜性心房颤动合并血栓形成的高危因素,炎症反应可能参与了心房内血栓的形成。
关键词(KeyWords): 心房颤动;C反应蛋白质;血栓形成
基金项目(Foundation):
作者(Author): 金彦彦,马长生,何华,刘小慧,董建增,刘兴鹏,龙德勇,喻荣辉
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