摘要
目的探讨房颤患者行左心耳封堵术后对左心房结构及功能的影响。方法前瞻性随访因房颤行左心耳封堵术,术后该我院常规复查的47例患者。对比术前与术后各时间节点(1个月、3个月、6个月、12个月和24个月)患者左心房结构和功能参数的变化趋势,随访指标包括:血浆心纳肽(ANP)浓度、左心房最大前后径(LADmax)、最大面积(LAAmax)、最大容积(LAVmax)、左心房主动排空分数(LAAEF)、被动排空分数(LAPEF)和总排空分数(LAEF)。结果与术前比较,术后1、3、6、12、24个月血浆ANP的浓度比较,差异无统计学意义(P>0.05);LADmax、LAAmax和术后1个月和3个月逐渐减小,差异有统计学意义(P<0.05),但术后6个月(包括6个月)后趋于平稳,差异无统计学意义(P>0.05);反映左心房储存功能的LAEF和LAAEF,差异无统计学意义(P>0.05);反映左心房管道功能的LAPEF术后增高,差异有统计学意义(P<0.05),其中术前1、3个月逐渐上升(P<0.05),但6个月(包括6个月后)之后趋向稳定,差异无统计学意义(P>0.05)。结论房颤患者行左心耳封堵术后左心房的ANP分泌功能、储存功能和收缩功能无显著改变。但左心房的大小和容积于术后1个月和3个月内缩小,同时左心房的管道功能得到改善,且这些指标于术后6个月(包括6个月)趋于稳定。
Objective To investigate the effects of left atrial appendage occlusion(LAAO)on the left atrial structure and function in patients with atrial fibrillation.Methods The prospective follow-up was performed in 47 patients with atrial fibrillation who underwent LAAO in our hospital.The changes of left atrial structural and functional parameters were observed and compared between preoperative and postoperative time points(1 month,3 months,6 months,12 months,and 24 months).The follow up indexes included atrial natriuretic peptide(ANP)concentration in plasma,the maximum anteroposterior diameter,area and volume of left atrium(LA),left atrial active emptying score,passive emptying score and total emptying score.Results As compared with those before operation,there were no significant differences in plasma levels of ANP in postoperative follow-up time points(1m,3m,6m,12m and 24m after LAAO)(P>0.05).The LAD max,LAA max and volume of LA were gradually decreased at 1m and 3m after operation,and the differences were statistically significant(P<0.05),however,which became stable at 6m after operation,there were no significant differences(P>0.05),moreover there were no significant changes in the total left atrial emptying fraction(LAEF)and the active pumping fraction(LAAEF)(P>0.05).The left atrial passive emptying fraction(LAPEF)was significantly increased after LAAO(P<0.05),which were gradually increased from 1m to 3m after surgery(P<0.05),however,which became stable at 6m after operation,there were no significant differences(P>0.05).Conclusion There are no significant changes in ANP secretion,storage function and systolic function in patients with atrial fibrillation after LAAO.However,the size and volume of the LA are decreased within 1 month and 3 months after surgery,meanwhile,the transportation function of LA is improved,and these indexes become stable at 6 months after surgery.
作者
张艳
李晓云
姬冬辉
ZHANG Yan;LI Xiaoyun;JI Donghui(Department of Ultrasonography,Xingtai People’s Hospital,Hebei,Xingtai 054031,China)
出处
《河北医药》
CAS
2020年第11期1629-1632,共4页
Hebei Medical Journal
基金
河北省医学科学研究重点课题计划(编号:20201571)。
关键词
左心耳封堵术
左心房
心纳肽
结构与功能
left atrial appendage occlusion
left atrium
atrial natriuretic peptide
structure and function
