本文選題：心房動顫 + 左心房血栓　； 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:探討心房顫動患者左心房血栓形成的危險因素。方法:收集資料完整的2009年01月-2014年10月在我院住院并行心房顫動射頻消融的心房顫動患者113例,其中男性75例,女性38例;分為左心房血栓組16例和無血栓組97例。收集患者的年齡、性別、既往病史(高血壓、糖尿病、冠心病),凝血功能相關(guān)指標(FIB、INR);所有患者均行經(jīng)食道心臟彩色超聲,收集心臟彩超數(shù)據(jù)(左房內(nèi)徑、左室舒末徑、EF值);心臟CT檢查(心臟CT心房三維重建),將左心耳形態(tài)分為仙人掌型、雞翅型、菜花型、風(fēng)向袋型;結(jié)果:113例心房顫動患者中左心房血栓者16例,發(fā)生率14.16%,兩組患者在病程、心房顫動分類、高血壓、冠心病、左室舒末徑、EF值、FIB、INR方面比較均無統(tǒng)計學(xué)差異(均P0.05)。女性患者左心房血栓發(fā)生率(33.68%)較男性高(9.33%),P0.05;血栓組年齡(62.31±6.457歲)較無血栓組(53.81±11.225歲)大,P0.01;血栓組中糖尿病所占比例(25%)較無血栓組(6.2%)高,P0.05;血栓組左房內(nèi)徑(42.88±6.888mm)較無血栓組(37.21±6.185)大,P0.01;菜花型左心耳患者左心房血栓陽性率(30.77%)較其他類型高,P0.05;Logistic回歸結(jié)果示年齡(OR=1.124,P=0.041)、糖尿病(OR=16.803,P=0.013)、左房內(nèi)徑(OR=1.121,P=0.048)是心房顫動患者左心房血栓形成的危險因素。結(jié)論:心房顫動患者左心房血栓形成的危險因素有年齡、性別(女性)、糖尿病、左房內(nèi)徑、左心耳解剖形態(tài),其中年齡、糖尿病、左房內(nèi)徑是左心房血栓形成的獨立危險因素。
[Abstract]:Objective: to investigate the risk factors of left atrial thrombosis in patients with atrial fibrillation. Methods: from January 2009 to October 2014, 113 patients with atrial fibrillation underwent radiofrequency ablation of atrial fibrillation, including 75 males and 38 females, were divided into left atrial thrombus group (n = 16) and non-thrombotic group (n = 97). Age, sex, past medical history (hypertension, diabetes, coronary heart disease, coagulation function related indexes) were collected. All patients underwent transesophageal echocardiography and collected echocardiographic data (left atrial diameter, left atrial diameter). Left ventricular diastolic diameter and EF value, cardiac CT scan (cardiac CT atrial three-dimensional reconstruction, left atrial auricular shape divided into cactus type, chicken wing type, cauliflower type, wind bag type, results of 113 patients with atrial fibrillation in 16 cases, left atrial thrombosis, The incidence rate was 14.16%. There was no significant difference in course of disease, classification of atrial fibrillation, hypertension, coronary heart disease, EF value of left ventricular diastolic diameter and FIBN INR between the two groups (all P 0.05). The incidence of left atrial thrombus in female patients (33.68%) was higher than that in men (P 0.05; the thrombus group was 62.31 鹵6.457 years old); the thrombus group was 53.81 鹵11.225 years old; the proportion of diabetes mellitus in the thrombus group was 25.5% higher than that in the non-thrombus group (P 0.05); the left atrial diameter in the thrombus group was 42.88 鹵6.888mm) and the left atrial diameter was 37.21 鹵6.185 mm in the thrombus group. The positive rate of left atrial thrombus in the patients with cauliflower type of left atrial appendage was 30.777.The logistic regression analysis showed that the risk factors of left atrial thrombosis in patients with atrial fibrillation were as follows: age = 1.124P = 0.041, DM = 16.803 / P 0.013, left atrial diameter = 1.121P 0.048). Conclusion: the risk factors of left atrial thrombosis in patients with atrial fibrillation are age, sex (female, diabetes, left atrial diameter, left atrial appendage anatomy, age, diabetes, left atrial diameter are independent risk factors of left atrial thrombosis.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.75

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