文佳 张敏 郭丽萍 秦朗

    [摘要] 目的 評估经食管超声心动图对房颤患者左心耳血栓的预测价值。 方法 选取2012年10月～2018年1月柳州市工人医院收治的148例房颤患者，根据患者是否存在左心耳血栓将其分为血栓组(22例)和非血栓组(126例)。所有患者均经食管超声心动图以及增强CT检查，观察两组患者左心耳超声心动图参数。以临床诊断为“金标准”，比较两种检查方式诊断左心耳血栓的真阳性率、假阳性率、真阴性率、假阴性率、灵敏度、特异度和准确度。 结果 血栓组患者心脏舒张期左心耳最大面积(LAA-max)、心脏收缩期左心耳最小面积(LAA-min)水平均明显高于非血栓组，差异有统计学意义(P 0.05)。经食管超声心动图诊断房颤患者左心耳血栓的真阳性率、真阴性率分别为90.91%(20/22)、90.48%(114/126)，均明显高于增强CT的63.64%(14/22)、61.90%(78/126)(均P < 0.05)。经食管超声心动图诊断患者左心耳血栓的灵敏度、特异度以及准确度分别为90.91%、90.48%及90.54%，均明显高于增强CT检查的63.64%、61.90%、62.16%(均P < 0.05)。 结论 房颤左心耳血栓患者LAA-max、LAA-min异常升高，经食管超声心动图对房颤患者左心耳血栓有很好的预测价值。

    [关键词] 心房颤动；左心耳血栓；经食管超声心动图；增强CT；预测价值

    [中图分类号] R540.45；R541.75 [文献标识码] A [文章编号] 1673-7210(2018)10(a)-0138-04

    The prognostic value of esophageal echocardiography in patients with atrial fibrillation in patients with atrial fibrillation

    WEN Jia ZHANG Min GUO Liping QIN Lang

    Department of Ultrasound Diagnostics， Liuzhou Worker′s Hospital， Guangxi Zhuang Autonomous Region， Liuzhou 545005， China

    [Abstract] Objective To evaluate the predictive value of esophageal echocardiography in patients with atrial fibrillation in patients with atrial fibrillation. Methods A total of 148 patients with atrial fibrillation admitted to the Liuzhou Workers′ Hospital from October 2012 to January 2018 were selected and divided into thrombus group (22 cases) and the non-thrombotic group (126 cases). Trans-esophageal echocardiography and enhanced CT were performed in all patients ......