本文關(guān)鍵詞：心房顫動(dòng)患者射頻消融手術(shù)前后左心房結(jié)構(gòu)及功能的對(duì)照研究　出處：《石河子大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的評(píng)價(jià)非風(fēng)濕性心房顫動(dòng)(房顫)患者射頻消融手術(shù)前后左心房結(jié)構(gòu)及功能的變化。方法非風(fēng)濕性性房顫(Non rheumatic atrial fibrillation,NRAF)患者200例,其中100例行射頻消融手術(shù)者為射頻消融組,100例行藥物保守治療者為保守治療組。2組治療前及治療后1 a后均行經(jīng)食管超聲心動(dòng)圖檢查,和血腦鈉肽(Brain natriuretic peptide,BNP)、高敏C反應(yīng)蛋白(hugh C-reactive prote,hs-CRP)水平測定,比較2組左心房、左心耳結(jié)構(gòu)和功能變化以及血清BNP、hs-CRP水平。結(jié)果射頻消融組和保守治療組治療前左房內(nèi)徑(Left atrial diameter,LAD)[(45.3±3.2)、(45.1±2.6)mm]、左心房最大容積(Left atrial maximum volume,LAVmax)[(75.9±5.1)、(76.3±4.2)m L]、左心房容積指數(shù)(Left atial volume index,LAVI)[(97.4±8.3)、(98.3±5.1)m L/m2]、左心耳最大容積(Left atrial appendage maximum volume,LAAVmax)[(7.0±0.8)、(6.8±0.9)m L]、左心房射血數(shù)(Left atrial ejection fraction,LA-EF)[(47.5±5.6)%、(48.2±4.5)%]、左心耳射血分?jǐn)?shù)(left atrial appendage ejection fraction,LAA-EF)[(17.1±2.7)%、(17.5±1.9)%]、左心耳最大排空速度[(Left atrial appendage emptying maxiumun speed,LAA-PEV)]、左心室射血分?jǐn)?shù)[(left ventricular ejection fraction,LVEF)[(59±1.7)%、(59.1±2.2)%]以及血BNP[(47.1±6.5)、(46.2±8.4)ng/L]、hs-CRP[(8.54±2.21)、(7.91±3.1)mg/L]比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05);治療后1 a,2組以上指標(biāo)均較治療前改善,且射頻消融組LAD[(35.6±3.4)mm]、LAVmax[(66.5±4.4)m L]、LAVI[(72.6±5.4)m L/m2]、LAAVmax[(4.1±0.5)m L]以及血BNP[(17.8±5.3)ng/L]、hs-CRP[(4.23±1.6)mg/L]低于保守治療組[(39.2±2.1)mm、(72.7±3.1)m L、(89.4±2.7)m L/m2、(4.5±0.6)m L、(30.1±6.3)ng/L、(5.5±2.2)mg/L],LAA-PEV[(38.1±6.5)cm/s]、LAA-EF[(22.2±3.5)%]、LAEF[(55.6±5.3)%]、LVEF[(65±1.4)%]高于保守治療組[(33.6±7.3)cm/s、(20.2±3.1)%、(51.1±5.7)%、(60.1±1.1)%],2組比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論導(dǎo)管射頻消融術(shù)可逆轉(zhuǎn)NRAF患者左心房和左心耳結(jié)構(gòu)及功能。
[Abstract]:Objective to evaluate the changes of left atrial structure and function in patients with non-rheumatic atrial fibrillation (AF) before and after radiofrequency ablation. Non rheumatic atrial fibrillation. Of 200 patients with NRAF, 100 underwent radiofrequency ablation. Transesophageal echocardiography was performed before and 1 year after treatment in 100 cases of conservative drug therapy in group 2. And brain natriuretic peptide (BNP), high sensitive C-reactive prote (C-reactive prote), and brain natriuretic peptide (BNP). The level of hs-CRP was measured and the changes of structure and function of left atrium and left atrial appendage and serum BNP were compared between the two groups. Results the left atrial diameter of left atrium in radiofrequency ablation group and conservative treatment group before treatment was Left atrial diameteral LAD). [Left atrial maximum volume: left atrial maximum volume LAVmax. 45.3 鹵3.2mm. [Left atrial volume index (Left atial volume index LAVI). [97.4 鹵8.3 鹵8.1 m / m ~ (2) m ~ (-1) m ~ (-1 / m ~ (2)). Left atrial appendage maximum volume max. of left atrial appendage. [Left atrial ejection fractionation LA-EFL, Left atrial ejection fractionation (Left atrial ejection fractionation LA-EFL), left atrial ejection number (Left atrial ejection fractionation LA-EFL). [47.5 鹵5.6% (48.2 鹵4.5%). Left atrial appendage ejection fractionation (LAA-EFL). [17.1 鹵2.7 鹵17.5 鹵1.9%, maximum left atrial appendage emptying velocity. [Left atrial appendage emptying maxiumun speed LAA-PEV], left ventricular ejection fraction. [Left ventricular ejection fractionation (LVEF). [59 鹵1. 7% and 59. 1 鹵2. 2% of BNP in blood. [46.2 鹵8.4 ng / L] hs-CRP. [There was no significant difference between 8.54 鹵2.21 mg / L and 7.91 鹵3.1 mg / L; More than one year after treatment, the above indexes were improved in both groups, and LAD in radiofrequency ablation group was improved. [Lavmax 35.6 鹵3.4 mm. [6. 5 鹵4. 4mL] Levi. [72.6 鹵5.4 m L / m 2] LAAVmax. [4. 1 鹵0. 5 mL and blood BNP. [17.8 鹵5.3 ng / L] hs-CRP. [4.23 鹵1.6 mg / L was lower than that in conservative treatment group. [39.2 鹵2.1 m ~ (-1) m ~ (-1) + 72.7 鹵3.1 m ~ (-1) m ~ (-1) Li ~ (89.4 鹵2.7) m ~ (-1) 路m ~ (2) ~ (-1) ~ (4) 鹵0.6 ~ (-1) m ~ (-1). 30.1 鹵6.3 ng / L = 5.5 鹵2.2 mg / L] LAA-PEV. [38.1 鹵6.5 cm / s] LAA-EF. [Lef 22.2 鹵3.5%. [55.6 鹵5.3%] LVEF. [65 鹵1.4%] was higher than that in conservative treatment group. [33.6 鹵7.3 cm / s / s = 20.2 鹵3.1% and 51.1 鹵5.7%, 60.1 鹵1.1% respectively. Conclusion radiofrequency catheter ablation can reverse the structure and function of left atrium and left atrial appendage in patients with NRAF.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R541.75
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本文編號(hào)：1415153