摘要
目的:探讨纤维蛋白原(Fib)与非瓣膜性心房颤动(NVAF)患者左心耳血栓状态(LAATM)之间的相关性。方法:连续入选2016年1月—2020年1月于河北医科大学第二医院心内科符合标准的NVAF患者696例,根据术前经食管超声心动图结果将患者分为LAATM组(88例)和无LAATM组(608例)。采用单因素及多因素logistic回归分析Fib是否与NVAF患者LAATM具有相关性,并利用受试者工作特征(ROC)曲线评估Fib对于判断是否存在LAATM的效能。结果:与无LAATM组相比,LAATM组的年龄、舒张压、心率、心房颤动类型、心房颤动病史>1年、饮酒、高血压、心力衰竭、脑卒中、CHA2DS2-VASc、D-二聚体、Fib、脑钠肽(BNP)、中性粒细胞/淋巴细胞比值(NLR)、左心耳排空速度、e’、左房直径、左室收缩末期容积、左室射血分数经单因素分析,其差异有统计学意义(P<0.05)。且LAATM组患者的Fib水平高于无LAATM组(P<0.001)。多因素回归分析显示Fib仍是NVAF患者LAATM的独立危险因素(OR=2.23,95%CI1.297~3.833,P=0.004)。ROC曲线下面积为0.63(95%CI0.56~0.70,P<0.001);当Fib=2.825g/L时,患者可能存在LAATM(敏感度为77.27%,特异度为44.74%)。结论:在NVAF患者中,Fib是存在LAATM的独立危险因素,在评估LAATM是否存在时,Fib具有一定参考价值。
Objective:To investigate the relationship between fibrinogen(Fib)and left atrial appendage thrombogenic milieu(LAATM)in patients with non-valvular atrial fibrillation(NVAF).Methods:We retrospectively selected a total of 696patients with NVAF who met the criteria in the Department of Cardiology of the Second Hospital of Hebei Medical University from January 2016to January 2020.According to the results of transesophageal echocardiography before operation,the patients were divided into LAATM group(n=88)and non-LAATM group(n=608).Univariate and multivariate logistic regression were used to analyze whether Fib was correlated with LAATM in patients with NVAF,and the efficacy of Fib in judging the existence of LAATM was evaluated by the receiver's work certificate curve(ROC).Results:Compared with non-LAATM group,age,diastolic blood pressure,heart rate,type of atrial fibrillation,history of atrial fibrillation>1year,drinking,hypertension,heart failure,stroke,CHA2DS2-VASc,D-dimer,Fib,BNP,NLR,left atrial appendage emptying velocity,e',left atrial diameter,left ventricular end-systolic volume and left ventricular ejection fraction in LAATM group were statistically significant by univariate analysis.And the level of Fib in LAATM group was higher than that in non-LAATM group(P<0.001).Multivariate regression analysis showed that Fib was still an independent risk factor for LAATM in patients with NVAF(OR=2.23,95%CI1.297-3.833,P=0.004).The area under the ROC curve was 0.63(95%CI0.56-0.70,P<0.001);when Fib=2.825g/L,the patient may suffered LAATM(sensitivity:77.27%,specificity:44.74%).Conclusion:In patients with NVAF,Fib is an independent risk factor for the existence of LAATM.Fib has a certain reference value in evaluating the existence of LAATM.
作者
马建帅
何长健
袁明
朱娜娜
张艳
刘倩
马立衡
王世伟
尤玲
谢瑞芹
MA Jianshuai;HE Changjian;YUAN Ming;ZHU Nana;ZHANG Yan;LIU Qian;MA Liheng;WANG Shiwei;YOU Ling;XIE Ruiqin(Department of Cardiology,The Second Hospital of Hebei Medical University,Shijiazhuang,050000,China)
出处
《临床心血管病杂志》
CAS
北大核心
2021年第9期796-801,共6页
Journal of Clinical Cardiology
基金
河北省重点研发计划民生科技专项(No:20377730D)。
关键词
心房颤动
纤维蛋白原
左心耳
血栓
atrial fibrillation
fibrinogen
left atrial appendage
thrombogenic milieu
