经食道超声与左心声学造影对心房颤动患者诊断左心耳血栓的价值分析

Value of transesophageal echocardiography combined with left atrial contrast echocardiography in diagnosis of left atrial appendage thrombus in patients with atrial fibrillation

目的 探究经食道超声(TEE)联合左心声学造影(LACE)对心房颤动(房颤)患者诊断左心耳血栓的价值。方法 随机选取2020年1月至2021年8月于唐山中心医院心内科择期行射频消融术治疗的患者90例作为研究对象。所有患者术前均行经食道超声及左心声学造影,按照检测方法不同分为TEE组及LACE组。收集患者的临床资料,采用经食道超声或左心声学造影检测房颤患者左心耳血栓结果。比较两组左心耳血流速度、左心耳射血分数、左心室容积、左心房容积、左室射血分数等变化。结果经食道超声检测和左心声学造影检测房颤患者的左心耳血栓和SCE检出率的灵敏度和特异度和检出率,两种检测方法均无统计学意义(P>0.05)。对同一房颤患者先后采用经食道超声检查和左心声学造影检查左心耳,左心房和左心室包括左心耳血流速度,左心耳射血分数等各项指标显示,两种检查的差异均无统计学意义,(P>0.05)。结论 经食道超声检测和左心声学造影房颤患者诊断左心耳血栓形成具有较高的诊断价值,且两者联合检测具有较高的一致性。

Objective To study the value of transesophageal echocardiography(TEE) combined with left atrial contrast echocardiography(LACE) in the diagnosis of left atrial appendage thrombus(LAAT) in patients with atrial fibrillation(AF). Methods The patients(n=90) with planed radiofrequency ablation(RFA) were randomly chosen from Department of Cardiology in Tangshan Central Hospital from Jan. 2020 to Aug. 2021. All patients were given examinations of TEE and LACE before RFA, and divided into TEE group and LACE group. The clinical materials were collected from all patients, and LAAT was detected by applying results of TEE or LACE. The changes of flow velocity and ejection fraction of left atrial appendage, left ventricular volume, left atrial volume and left ventricular ejection fraction(LVEF) were compared in 2 groups. Results There was no statistical significance in sensitivity,specificity and detection rate for detecting LAAT and SCE by using TEE or LACE(P>0.05) in AF patients. In a same AF patient, TEE and LACE were successively applied to detect flow velocity and ejection fraction of left atrial appendage, and results showed that there was no statistical significance(P>0.05) between 2 methods. Conclusion TEE and LACE have a higher value in the diagnosis of LAAT in AF patients, and combination of TEE and LACE has a high consistency in LAAT detection.