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目的 :探讨经食管超声心动图 (TEE)检查和测定血浆凝血标志物用于评估非风湿性房颤 (NRAF)栓塞危险性价值。方法 :对 12 4例的研究对象全部测定血浆中凝血标志物 ,对风湿性房颤 (RAF)组 3 2例和NRAF组 3 4例实施常规经胸超声心动图 (TTE)和TEE检查。结果 :①TEE的心房血栓和左房自发性超声对比 (LASEC)现象检出率显著高于TTE(P <0 0 1) ;左心耳 (LAA)血流排空速率降低 ( <2 5cm/s)与心房血栓和LASEC形成密切相关。②四种血浆中凝血标志物水平在NRAF组均显著高于正常对照组 (P <0 0 1) ;其中D 2聚体水平在LAA功能减退患者中显著升高 (P <0 0 1)。结论 :①TEE较TTE在评估NRAF栓塞危险性方面具更高的应用价值 ;心房内存在血栓、LASEC阳性 ,LAA血流排空速率下降是三项重要的TEE评估指标。②心房颤动可导致某些特异性凝血标志物水平显著升高。③D 2聚体浓度升高与TEE评估指标高度相关
Objective: To investigate the value of transesophageal echocardiography (TEE) and determination of plasma coagulation markers in assessing the risk of non-rheumatic atrial fibrillation (NRAF) embolism. Methods: Totally 12 4 plasma coagulation markers were determined in plasma samples. Conventional transthoracic echocardiography (TTE) and TEE were performed in 32 patients with rheumatic atrial fibrillation (RAF) and 34 patients with NRAF. Results: (1) The detection rate of atrial thrombus and left atrial spontaneous contrast (TEAS) in TEE was significantly higher than that in TTE (P <0.01); the rate of blood flow evacuation in LAA decreased (<2 5 cm / s) And atrial thrombosis and LASEC formation is closely related. ② The levels of coagulation markers in four plasma were significantly higher in NRAF group than those in normal control group (P <0.01). The level of D 2 dimer was significantly increased in patients with LAA hypofunction (P <0.01). Conclusion: (1) TEE is more valuable than TTE in assessing the risk of embolization of NRAF. Thrombus in the atria, positive LASEC, and decreased blood flow rate of LAA are three important TEE indicators. Atrial fibrillation can lead to significant increases in the level of certain specific coagulation markers. Â ’¢ D 2 polymer concentration and TEE assessment of highly relevant indicators