超声心动图对左心室血栓抗凝疗效的预测价值

摘要/Abstract

摘要： 目的探讨超声心动图在预测左心室血栓（LVT）早期抗凝疗效及预后中的价值。方法回顾性分析2019年4月至2025年3月在江苏省中医院确诊为LVT的门诊及住院患者75例,于抗凝治疗1月时复查超声心动图,根据LVT的溶解情况,分为早期溶解组（1月内溶解）及晚期溶解组（1月后溶解）。收集两组患者基线的临床资料、超声心动图结构功能参数及血栓特征参数、随访期间主要不良心血管事件（MACE）发生情况,所得数据纳入统计学分析。结果与晚期溶解组相比,早期溶解组的血栓横径（23.5±13.3 vs 15.7±9.4 mm, P=0.009）、纵径（13.5±6.8 vs 10.6±4.3 mm,P=0.048）及横截面积（320.9±143.6 vs 140.8±100 cm²,P=0.002）更小,球状血栓（38.8 vs 61.5 %,P=0.045）、回声较低（18.4 vs 34.6 %,P=0.029）及高度活动（4.1 vs 15.4 %,P=0.008）的血栓占比更高。多因素Logistic回归分析显示,血栓的回声强度（低回声OR=7.981,95%CI 1.087-58.580,P=0.041;中回声OR=6.211,95%CI 1.069-36.092,P=0.042）及活动度（部分活动OR=5.514,95%CI 1.188-25.603,P=0.029;高度活动OR=16.265,95%CI 1.429-85.161,P=0.025）是LVT早期溶解的独立预测因素。与早期溶解组相比,晚期溶解组的心源性病死率及总体MACE发生率更高。结论超声心动图检测的血栓回声强度及活动度是LVT早期溶解的独立预测因素,LVT晚期溶解与较差的预后相关。

关键词: 左心室血栓, 抗凝, 超声心动图, 主要不良心血管事件

曹佳莉, 何安霞. 超声心动图对左心室血栓抗凝疗效的预测价值[J]. 心血管病防治知识, 2025, 15(19): 31-35.

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