【摘要】 目的 :探讨经食管超声心动图 (TEE)测定左心耳 (L AA )功能用于评估非风湿性心房颤动 (房颤 )患者栓塞危险性的价值。方法 :46例非风湿性房颤患者同时接受常规经胸超声心动图 (TTE)及 TEE检查。根据 TEE测定的L AA血流排空速率将患者分为低流速组 (<2 5 cm/ s,n=18)和高流速组 (≥ 2 5 cm/ s,n=2 8) ,对两组间心房血栓和左房自发性超声对比现象 (L ASEC)检出率及其它预示栓塞危险性的临床 ,TTE指标进行对比分析。结果 :低流速组心房血栓及 L ASEC检出率显著高于高流速组 (P<0 .0 1)。L AA面积扩大与其排空速率降低密切相关 (r=- 0 .5 44 ,P<0 .0 1)。继往栓塞事件、左室功能不全和左房扩大均以低流速组明显 (P<0 .0 5 ) ,而年龄、高血压病史、糖尿病病史在两组间未存在显著差异 (P>0 .0 5 )。结论 :TEE测定左心耳功能有助于区分非风湿性房颤患者中的栓塞高危人群。更多还原

【Abstract】 AIM:To explore the value of transesophageal echocardiographic assessment of left atrial appendage(LAA) function for identifying thromboembolic risk in patients with nonrheumatic atrial fibrillation. METHODS:Transthoracic and trnsesophageal echocardiographic examinations were performed in 66 patients with nonrheumatic atrial fibrillation. The patients were divided into two groups according to the LAA blood emptying velocity assessed by transesophageal echocardiography:group I(<25 cm/s, n =18) and group Ⅱ(≥25 cm/s, n =28). The incidences of left atrial thrombus and spontaneous echo contrast as well as other clinical and echocardiographic factors associated with throboembolism were compared between the two groups. RESULTS:In group Ⅰ,the incidences of atrial thrombus and spontaneous echo contrast were significantly higher than those in groupⅡ ( P <0.01), and LAA enlargement was closely correlated with reduced LAA blood velocity ( r =-0.544, P <0.01). Previous embolic events,left atrial diameter dilatation and left ventricular dysfunction were common in group Ⅰ than in group Ⅱ ( P <0.05), but no significant differences were observed in age,history of hypertension and diabetes( P >0.05). CONCLUSION:Left atrial appendage function assessed by transesophageal echocardiography may be helpful for identifying subgroup of patients with nonrheumatic atrial fibrillation at higher thromboembolic risks.更多还原