Abstract：【Objective】To explore the value of ultrasonic imaging and laboratory indexes in predicting the risk of left atrial thrombosis in rheumatic heart disease. 【Methods】 The clinical data of 103 patients with rheumatic heart disease admitted to our hospital from August 2020 to August 2021 were analyzed retrospectively. The patients were divided into thrombus group (n=27) and non thrombus group (n=76) according to whether they had left atrial thrombosis. Gender, age, body mass index (BMI), course of disease, hypertension, diabetes, left atrial systolic diameter, left atrial area, left atrial spontaneous echo, activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), lysophosphatidic acid (LPA), antithrombin-Ⅲ (AT-Ⅲ) were compared between the two groups. The value of ultrasonic imaging and laboratory indexes in predicting left atrial thrombus in patients with rheumatic heart disease was analyzed by subject operating characteristic curve (ROC); Logistic stepwise regression was used to analyze related risk factors in multivariate analysis. 【Results】The ratio of left atrial systolic diameter, left atrial area, LPA and left atrial spontaneous echo in the thrombosis group was higher than that in the non thrombosis group, while AT-Ⅲ was lower than that in the non thrombosis group (P<0.05). ROC curve analysis showed that the area under the curve of left atrial systolic diameter, left atrial area, LPA, AT-Ⅲ predicting left atrial thrombosis in patients with rheumatic heart disease were 0.851, 0.825, 0.790, 0.844, respectively. Multivariate logistic analysis showed that left atrial systolic diameter ≥ 52.375 mm, left atrial area ≥ 30.480 cm2, left atrial spontaneous echo, LPA ≥ 3.700 μmol/L and AT-Ⅲ≤ 24.985% were risk factors for left atrial thrombosis in patients with rheumatic heart disease (P<0.05). The consistency analysis showed that the sensitivity, specificity and accuracy of predicting left atrial thrombosis in patients with rheumatic heart disease combined with ultrasonic imaging and laboratory indicators were 0.926, 0.961 and 0.951 respectively,Kappa=0.876. 【Conclusion】The combination of ultrasonic imaging and laboratory indexes has a high value in predicting the risk of left atrial thrombosis in rheumatic heart disease, which is conducive to the early diagnosis and treatment of rheumatic heart disease with left atrial thrombosis.
校王莉, 贾贝. 超声影像学及实验室指标联合预测风湿性心脏病发生左心房血栓风险的价值[J]. 医学临床研究, 2022, 39(11): 1650-1653.
XIAO Wang-li, JIA Bei. Value of Ultrasound Imaging and Laboratory Indexes in Predicting the Risk of Left Atrial Thrombosis in Rheumatic Heart Disease. JOURNAL OF CLINICAL RESEARCH, 2022, 39(11): 1650-1653.
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2022, Vol. 39 
