作　　者： (梁峰）; (刘国华）; (朴雪梅）;

机构地区： 北京市平谷区医院超声科,北京101200

出　　处： 《医学临床研究》 2017年第8期1545-1547,共3页

摘　　要： 【目的】探讨超声心动图对评估非瓣膜性心房颤动（房颤）患者卒中风险的评估价值。【方法】回顾性分析91例非瓣膜性房颤患者心脏超声资料，根据是否发生卒中分为卒中组（38例）和无卒中组（53例）；并与近期收治的、按临床症状进行房颤风险评估的非瓣膜性房颤患者102例作为对照。以上患者均行超声心动图测量右房内径（RAD）、室间隔厚度（IVS）、左室内径（LVD）、左室后壁厚度（LVPW）及左房内径（LAD）。对照组患者进一步作CHADS2和CHA2DS2-VASc症状评分与心脏结构参数的相关性分析。【结果】回顾性研究结果提示IVS（OR=2．698，P=0．018）、LVPW（OR=2．703，P=0．013）、LAD（OR=3．708，P=0．022）是非瓣膜性房颤患者发生卒中的危险因素。临床表现评分与心脏超声参数相关性分析表明，非瓣膜性房颤患者的CHADS2评分与RAD（rs=0．562，P=0．020）、IVS（rs=0．497，P=0．013）、LVPW（rs=0．398，P=0．046）、LAD（rs=0．701，P=0．007）呈显著正相关，而CHA2DS2-VASc评分与IVS（rs=0．668，P=0．019）、LvPw（rs=0．481，P=0．032）、LAD（r2=0．649，P=0．011）呈显著正相关。【结论】超声心脏结构指标对预测非瓣膜性房颤患者卒中风险有一定的指导意义。 [Objective]To explore the significance of ultrasound cardiac structure in evaluation of non-val- vular atrial fibrillation （AF） stroke risks. [Methods] A total of 91 AF patients, including 38 cases with stroke and 53 cases without stroke were collected retrospectively. The data were compared to 102 recently recruited AF patients, who served as the control group. All the subjects above accepted ultrasonic cardiogram to detect right atrium diameter （RAD）, interventricular septal thickness （IVS）, left ventricular diameter （LVD）, posterior wall of left ventricle （LVPW） and left atrium diameter （LAD）. Further analysis of the correlation be- tween clinic symptom scores （CHADS2 and CHA2DS2-VASc scores） and cardiac structural parameters in the control group were evaluated.[Results]The retrospective study indicated that IVS （OR= 2.698, P = 0.018）, LVPW （OR=2.703, P =0.013） and LAD （OR=3.708, P =0.022） were the risk factors of stroke in AF pa- tients. Our study also showed that RAD （rs =0.562, P =0.020）, IVS （r, =0.497, P =0.013）, LVPW （rs = 0.398, P =0.046） and LAD （rs=0.701, P =0.007） were positively correlated with CHADS2 scores in AF patients. Similarly, positive correlations were found between CHA2DS2 - VASc scores and IVS （rs = 0.668, P = 0.019）, LVPW （rs = 0.481, P = 0.032）, LAD （rs = 0.649, P = 0.011）. [Conclusion]Indicators of ultra- sound cardiac structure have a certain significance in predicting the risk of stroke in non-valvular atrial fibrillation patients.

关 键 词： 超声心动描记术 心房颤动 超声检查 颅内栓塞和血栓形成 卒中 危险因素