丁树生,宁彬

• 1:阜阳市人民医院心内科

摘要(Abstract)：

目的 探讨心房颤动（房颤）患者左心耳封堵术（LAAC）联合射频消融术后装置不完全内皮化的危险因素及临床影响。方法 收集2021年1—12月在阜阳市人民医院接受LAAC联合房颤射频消融术治疗并具有完整随访资料的非瓣膜性房颤患者60例。结果 术后3个月中位时间随访，心脏CTA检查发现装置完全内皮化患者19例，不完全内皮化患者37例，存在装置周围残余分流患者4例，所有患者均无不良心脑血管事件；术后6个月中位时间随访检查，发现装置不完全内皮化患者中仍有34例（装置不完全内皮化组）存在内皮化不全，其中有1例装置不完全内皮化患者术后6个月内并发脑卒中，完全内皮化患者22例（装置完全内皮化组），术后6个月4例患者装置残余分流仍然存在。两组患者年龄、性别、身体质量指数、吸烟史、CHA2DS2-VASc评分、HAS-BLED评分、既往病史、术中数据、术后抗凝药物、装置周围残余分流、装置相关血栓（DRT）、不良心脑血管事件比较，差异均无统计学意义（均P>0.05）；房颤类型和二尖瓣反流比较，差异均有统计学意义（P=0.011,P=0.029）。以持续性房颤和二尖瓣反流为自变量，装置是否完全内皮化患者为因变量行二元Logistic回归分析，持续性房颤（OR 4.378,95%CI 1.316～14.565,P=0.016）和二尖瓣反流（OR 3.629,95%CI 1.081～12.184,P=0.037）为影响LAAC装置不完全内皮化的独立危险因素。结论 装置不完全内皮化在LAAC后常见，尤其是在持续性房颤、二尖瓣反流患者中。装置不完全内皮化在短期可能不会增加DRT及不良心脑血管事件风险。

关键词(KeyWords)： 心房颤动;左心耳封堵;装置内皮化;装置相关血栓

Abstract:

Keywords:

基金项目(Foundation): 2021年度安徽省卫生健康委科研项目立项项目（AHWJ2021b070）

作者(Author): 丁树生,宁彬

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