急性脑梗死患者伴左心房收缩不同步性探讨

Left Atrial Asynchrony in Patients with Acute cerebral infarction

心房内血栓形成是脑梗死的原因之一,本文通过比较并分析正常人与急性脑梗死患者的左心房收缩不同步性,旨在阐述这些急性脑梗死患者左房内同步性改变可能促使心房内血栓前状态的产生,并进一步探讨影响其同步性改变的主要因素。1资料与方法1.1一般资料：选2008年12月至2010年8月住院的急性脑梗死患者56例,均经头颅CT或MRI确诊,其中男33例,女23例,年龄52～88（75.52±8.91）岁;

Objective To evaluate the variation of left atrial synchronicity and its determinants in patients with acute cerebral infarction（ACI）.Methods 50 healthy controls and 56 patients with ACI were included in this study.The left atrial synchronicity was assessed by Tissue Doppler imaging.Measurements below the atrioventricular plane were selected on the left atrial（LA） free wall,interatrial septum（IAS）.The time difference from the onset of P wave to the onset of A wave at the left atrium（P-LA） and the IAS（P-IAS） was measured.Left atrial synchrony was defined as the difference between P-LA and P-IAS,and stepwise regression was made to determine the influence factors of LA synchrony variation in ACI group.Results 1.In patients with ACI,a significant increase in LA synchrony was observed compared with control group（P0.01）.2.Logistic regression analysis demonstrated that the change of left atrial synchronicity was one of the danger factors of ACI（OR：2.26,P0.05）;3.Multivariate stepwise regression analysis showed that SBP,AGE and LVMI entered the regression equation（Y=-61.24＋0.22SBP＋0.47AGE ＋0.27LVMI）.Conclusions In patients with ACI,significant LA asynchrony was documented,evaluated by noninvasive color tissue Doppler imaging.SBP,AGE and LVMI are the most important determinants of the left atrial asynchronicity in patients with ACI.