作者：王俊伟，杜利军，王旭，曾玲，申钊，侯博

单位：

1.056002河北省邯郸市第一医院超声医学科　2.056200河北省邯郸市，华北医疗健康集团峰峰总医院超声医学科　3.054199河北省邢台市，沙河市人民医院放射科　4.056002河北省邯郸市中心医院CT室

单位（英文）：

1.Department of Ultrasound Medicine, Handan First Hospital, Handan 056002, China2.Department of Ultrasound Medicine, Fengfeng General Hospital, North China Medical and Health Group, Handan 056200,China3.Department of Radiology, Shahe People's Hospital, Xingtai 054199, China4.Department of CT Room, Handan Central Hospital, Handan 056002, China

关键词：

　心房颤动；非瓣膜性心房颤动；血栓形成；经食管超声心动图；纤维蛋白原；红细胞分布宽度；预测

中图分类号：

R 541.75

DOI：

10.12114/j.issn.1008-5971.2023.00.210

基金项目：

河北省2021年度医学科学研究课题计划项目（20210723）

摘要：

　目的　分析经食管超声心动图（TEE）检查指标及纤维蛋白原（FIB）、红细胞分布宽度（RDW）对非瓣膜性心房颤动（NVAF）患者血栓形成的预测价值。方法　选取2020年1月至2022年1月河北省邯郸市第一医院收治的NVAF患者80例为研究对象。收集患者基线资料、TEE检查指标〔峰值排空流速（PEV）、三维射血分数（3D-EF）〕、FIB、RDW。根据患者血栓形成情况，将其分为血栓形成组31例和非血栓形成组49例。采用多因素Logistic回归分析探讨NVAF患者血栓形成的影响因素；采用ROC曲线分析PEV、3D-EF、FIB、RDW及其联合对NVAF患者血栓形成的预测价值。结果　血栓形成组PEV慢于非血栓形成组，3D-EF低于非血栓形成组，FIB、RDW高于非血栓形成组（P＜0.05）。多因素Logistic回归分析结果显示，PEV、3D-EF、FIB、RDW是NVAF患者血栓形成的影响因素（P＜0.05）。ROC曲线分析结果显示，PEV、3D-EF、FIB、RDW及其联合预测NVAF患者血栓形成的AUC分别为0.707〔95%CI（0.592，0.822）〕、0.737〔95%CI（0.628，0.846）〕、0.738〔95%CI（0.622，0.854）〕、0.736〔95%CI（0.623，0.849）〕、0.972〔95%CI（0.942，1.000）〕，最佳临界值分别为37.7 cm/s、40.3%、4.1 g/L、10.2%、-14.4，灵敏度分别为100.0%、100.0%、51.6%、100.0%、90.3%，特异度分别为49.0%、51.0%、100.0%、46.9%、95.9%。结论　PEV、3D-EF、FIB、RDW均对NVAF患者血栓形成有一定预测价值，而其联合对NVAF患者血栓形成有较高的预测价值。

英文摘要：

【Abstract】　Objective To analyze the predictive value of transesophageal echocardiography (TEE) examinationindexes, fibrinogen (FIB) and red blood cell distribution width (RDW) on thrombosis in patients with non valvular atrial fibrillation(NVAF) . Methods A total of 80 NVAF patients admitted to Handan First Hospital from January 2020 to January 2022 wereselected as the study subjects. Baseline data, TEE examination indexes [peak emptying velocity (PEV) , three dimensionlejection fraction (3D-EF) ] , FIB and RDW were collected. According to the thrombosis status of patients, they were divided intothrombosis group (n=31) and non thrombosis group (n=49) . Multivariate Logistic regression analysis was used to investigate theinfluencing factors of thrombosis in NVAF patients. ROC curve was used to analyze the predictive value of PEV, 3D-EF, FIB,RDW and their combination on thrombosis in patients with NVAF. Results PEV in thrombosis group was slower than that in nonthrombosis group, 3D-EF was lower than that in non thrombosis group, FIB and RDW were higher than those in non thrombosis group (P < 0.05) . Multivariate Logistic regression analysis showed that PEV, 3D-EF, FIB and RDW were the influencing factorsof thrombosis in NVAF patients (P < 0.05) . ROC curve analysis results showed that, AUC of PEV, 3D-EF, FIB, RDW and theircombination in predicting thrombosis in NVAF patients was 0.707 [95%CI (0.592, 0.822) ] , 0.737 [95%CI (0.628, 0.846) ] , 0.738[95%CI (0.622, 0.854) ] , 0.736 [95%CI (0.623, 0.849) ] , 0.972 [95%CI (0.942, 1.000) ] , the optimal critical values were 37.7cm/s, 40.3%, 4.1 g/L, 10.2%, -14.4, the sensitivity was 100.0%, 100.0%, 51.6%, 100.0%, 90.3%, and the specificity was 49.0%,51.0%, 100.0%, 46.9%, 95.9%, respectively. Conclusion PEV, 3D-EF, FIB and RDW all have certain predictive value forthrombosis in NVAF patients, and their combination has high predictive value for thrombosis in NVAF patients.

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