【作者】 江琼；

【导师】 李金国；

【作者基本信息】 福建医科大学 ， 影像医学与核医学， 2010， 硕士

【摘要】 目的1.应用超声心动图观察房颤患者环肺静脉左房线性消融术前后左房结构和功能的变化2.利用超声心动图探讨阿托伐他汀对房颤患者左房结构及功能影响方法入选2008年4月至2009年3月于福建医科大学附属协和医院心内科诊断阵发性房颤患者24例为对照组,均行环肺静脉左房线性消融术(CPVA),术前、术后均予空白对照。2009年4月至2010年3月行CPVA的阵发性房颤患者32例为实验组,术前、术后予阿托伐他汀干预。病人均于术前、术后1天、术后3天、术后5天、术后7天、术后一个月行超声心动图检查,图像存盘,检测病人的左房内径、舒张晚期A峰最大血流速度(VA)、左房充盈分数(AFF)、左房射血力(AEF)、二尖瓣环运动速度(Va),对所得结果进行统计学分析。结果1.左房前后径、左右径、上下径术后一个月均较术前减小(P<0.01)。实验组与对照组比较,由均值上看,实验组减少略明显于对照组,但两组对比未见统计学差异(P>0.05)。2. VA、AFF、AEF术后均明显低于术前(P<0.01),至术后一个月仍低于术前水平(P<0.01)。实验组与对照组比较,由均值上看,实验组略高于对照组,但两组对比未见统计学差异(P>0.05)。,3.实验组及对照组Va术后均明显低于术前水平(P<0.01),至术后一个月仍低于术前水平(P<0.01)。实验组与对照组比较,由均值上看,实验组略高于对照组,但两组对比未见统计学差异(P>0.05)。结论1.使用CPVA术治疗阵发性房颤成功者,左房结构重构可以发生逆转,左房功能术后明显减低,短期内不能恢复至术前水平。2.阿托伐他汀作用于阵发性房颤的患者,对左房结构及功能的短期影响不明显。更多还原

【Abstract】 Objectives1.To observe the changes of left atrial structure and fucntion in patients underwent circumferential pulmonary vein ablation plus left atrial linear ablation using echocardiogram.2.To investigate the effects of atorvastatin on left atrial fucntion and structure in patients with atrial fibrillation using echocardiogram.MethodsWe enrolled 24 patients with paroxysmal atrial fibrillation who were diagnosed in the department of cardiology at Union Hospital of Fujian Medical University between April 2008 and 2009 March.All patients underwent circumferential pulmonary vein ablation plus left atrial linear ablation(CPVA)and were received blank control before and after the procedure.32 patients with paroxysmal atrial fibrillation who underwent CPVA between April 2009 and 2010 March were in control group. In this groups,patients were assigned to receive atorvastatin before and after the procedure.Echocardiography was performed preoperatively,and immediately ,1 day,3day,5day,7day and 30day after surgery in all patients. Left atrial diameter,the peak velocity of A-wave in late diastole(VA),left atrial filling fraction(AFF),left atrial ejection force(AEF),the peak velocity of mitral annulus by tissue Doppler in late diastole(Va),were measured.Results1. One month after the procedure, left atrial anteroposterior dimension,inferosuperior dimension,mediolateral dimension were all decreased in both groups ,(P<0.01). Compared to control group , the atorvastatin group was more obvious on average,but there was not differece in statistics(P>0.05).2.In both groups, VA,AFF and AEF were distinctly decreased after the procedure(P<0.01),and were still below preoperative level one month after the procedure (P<0.01). Compared to control group , the atorvastatin group was more higher on average,but there was not differece in statistics(P>0.05).3. Va were significantly lower than preoperative level in both group after the procedure(P<0.01),and were still below preoperative level 1 month after the procedure (P<0.01). Compared to control group , the atorvastatin group was more higher on average,but there was not differece in statistics(P>0.05).Conclution1. If CPVA procedure were successfully performed in patients with atrial fibrillation, left atrial reconstitution can be reversed.Left atrial function would distinctly decreased after the procedure,and would not improve in a short time.2. The effects of Atorvastatin on left atrial fucntion and structure in patients with atrial fibrillation were not evident in a short time .更多还原