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目的评价年龄对非瓣膜病心房颤动(房颤)患者左心房血栓的影响。方法选择拟行导管射频消融完成经食管超声检查的房颤患者421例,根据年龄分为老年组(108例)和年轻组(313例)。根据是否存在左心房血栓又分为血栓组(26例)和无血栓组(395例)。各组间进行一般临床资料比较。结果老年组年龄、高血压、服用血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)的比例明显高于年轻组,非阵发性房颤的比例明显低于年轻组。老年组LVEF明显高于年轻组。血栓组非阵发性房颤、心力衰竭、栓塞史、服用ACEI/ARB的比例明显高于无血栓组。血栓组左心房直径明显大于无血栓组,LVEF明显低于无血栓组。logistic多因素分析显示,校正LVEF、心力衰竭、高血压、糖尿病、服用ACEI/ARB,左心房直径、非阵发性房颤、既往栓塞史是左心房血栓独立预测因素,老年不是左心房血栓独立危险因素。结论年龄不是非瓣膜病房颤患者心房血栓的预测因素。
Objective To evaluate the effect of age on left atrial thrombus in patients with nonvalvular atrial fibrillation (AF). Methods 421 patients with atrial fibrillation undergoing transesophageal echocardiography undergoing radiofrequency catheter ablation were selected and divided into the elderly group (n = 108) and the young group (n = 313) according to age. According to the existence of left atrial thrombus is divided into thrombosis group (26 cases) and no thrombosis group (395 cases). The general clinical data between groups were compared. Results The proportion of age, hypertension, ACEI / ARB in the elderly group was significantly higher than that in the young group, and the proportion of non-paroxysmal atrial fibrillation was significantly lower Young group. LVEF in the elderly group was significantly higher than in the young group. Thrombosis non-paroxysmal atrial fibrillation, heart failure, embolism history, taking ACEI / ARB was significantly higher than the proportion of non-thrombosis group. Thrombus group atrial diameter was significantly larger than the non-thrombus group, LVEF was significantly lower than the non-thrombosis group. Logistic multivariate analysis showed that correction of LVEF, heart failure, hypertension, diabetes, ACEI / ARB, left atrial diameter, non-paroxysmal atrial fibrillation, prior embolism was an independent predictor of left atrial thrombi, and elderly were not independent of left atrial thrombus Risk factors. Conclusion Age is not a predictor of atrial thrombosis in patients with nonvalvular atrial fibrillation.