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LA \u5e94\u53d8\u6d4b\u91cf\u7531\u4e00\u4f4d\u7ecf\u9a8c\u4e30\u5bcc\u7684\u64cd\u4f5c\u5458\u79bb\u7ebf\u8fdb\u884c\uff0c\u4f7f\u7528\u72ec\u7acb\u4e8e\u4f9b\u5e94\u5546\u7684\u8f6f\u4ef6\uff08TomTec \u6210\u50cf\u7cfb\u7edf\uff0c\u7248\u672c 1.4\uff09\uff0c\u5e76\u4f7f\u7528 QRS \u5f00\u59cb\u4f5c\u4e3a\u5fc3\u52a8\u5468\u671f\u7684\u53c2\u8003\u6765\u62a5\u544a\u7684 4 \u8154\u548c 2 \u8154\u89c6\u56fe\u7684\u5e73\u5747\u503c\u3002\u5e94\u53d8\u6d4b\u91cf\u53cd\u6620\u4e86\u5fc3\u52a8\u5468\u671f 3 \u4e2a\u9636\u6bb5 LA \u5fc3\u808c\u957f\u5ea6\u7684\u5cf0\u503c\u767e\u5206\u6bd4\u53d8\u5316\u3002LA\u5e94\u53d8\u6d4b\u91cf\u5728LA\u529f\u80fd\u7684\u50a8\u5b58\u671f\uff0c\u5bfc\u7ba1\u671f\u548c\u6536\u7f29\u671f\u8fdb\u884c\uff0c\u5206\u522b\u8868\u793a\u4e3a\u5de6\u5fc3\u623f\u5e94\u53d8\u5b58\u50a8\u529f\u80fd\uff08LASres\uff09\uff0c\u5bfc\u7ba1\u529f\u80fd\uff08LAScd\uff09\u548c\u5de6\u5fc3\u623f\u5e94\u53d8\u6536\u7f29\u529f\u80fd\uff08LASct\uff09\u3002Delta LASres \u88ab\u5b9a\u4e49\u4e3a LA LASres \u4ece\u57fa\u7ebf\u5230 3 \u4e2a\u6708\u968f\u8bbf\u7684\u7edd\u5bf9\u53d8\u5316\u3002<\/p>\n
2 \u540d\u72ec\u7acb\u4e13\u5bb6\u8bc4\u4f30\u5458\u5bf9 48 \u540d\u60a3\u8005\u7684\u968f\u673a\u6837\u672c\u8bc4\u4f30\u4e86 LAmax \u4f53\u79ef\u3001LASre \u548c LASct \u6d4b\u91cf\u7684\u89c2\u5bdf\u8005\u95f4\u53d8\u5f02\u6027\u3002\u76f8\u5173\u7cfb\u6570\u5206\u522b\u4e3a0.72\u30010.86\u548c0.78\u3002<\/p>\n
\u4f7f\u7528SPSS\u7248\u672c25\u8fdb\u884c\u7edf\u8ba1\u5206\u6790\u3002\u6bd4\u8f83\u6d88\u878d\u65b9\u5f0f\u548c\u8282\u5f8b\u7ed3\u5c40\u4e4b\u95f4\u4eba\u53e3\u7edf\u8ba1\u5b66\u548c\u8d85\u58f0\u5fc3\u52a8\u56fe\u53c2\u6570\u5dee\u5f02\u7684\u6570\u636e\u3002\u6240\u6709\u53d8\u91cf\u5747\u5448\u6b63\u6001\u5206\u5e03\u5e76\u4f7f\u75282\u56e0\u5b50\u65b9\u5dee\u5206\u6790\u8fdb\u884c\u5206\u6790\uff0c\u663e\u793a\u4e3a\u5e73\u5747\u503c\u00b1SD\u548c95%\u7f6e\u4fe1\u533a\u95f4\u3002\u4f7f\u7528ANCOVA\u5bf92\u4e2a\u8282\u5f8b\u7ec4\u8fdb\u884c\u6bd4\u8f83\uff0c\u4ee5\u8c03\u6574\u57fa\u7ebf\u5dee\u5f02\u3002\u5206\u7c7b\u503c\u8868\u793a\u4e3a\u767e\u5206\u6bd4\uff0c\u5e76\u4f7f\u7528 \u03c7 \u8fdb\u884c\u5206\u67902\u6d4b\u8bd5\u3002\u8fdb\u884cCox\u56de\u5f52\u5206\u6790\u4ee5\u68c0\u67e5\u4e0e3\u4e2a\u6708\u6d88\u9690\u671f\u540e\u9996\u6b21AF\u590d\u53d1\u65f6\u95f4\u76f8\u5173\u7684\u56e0\u7d20\u3002\u6ca1\u6709AF\u590d\u53d1\u7684\u60a3\u8005\u5728\u6700\u540e\u4e00\u6b21\u968f\u8bbf\u65f6\u88ab\u5ba1\u67e5\u3002\u5bf9\u6bcf\u4e2a\u53c2\u6570\u8fdb\u884c\u5355\u53d8\u91cf\u5206\u6790\u3002\u5bf9P<0.1\u7684\u53d8\u91cf\u8fdb\u884c\u4e86\u591a\u53d8\u91cfCox\u56de\u5f52\u5206\u6790\u3002\u4f7f\u7528\u65b9\u5dee\u81a8\u80c0\u56e0\u5b50\u68c0\u9a8c\u53d8\u91cf\u4e4b\u95f4\u7684\u5171\u7ebf\u6027\uff0c\u5e76\u4eceCox\u56de\u5f52\u5206\u6790\u4e2d\u6d88\u9664\u5177\u6709\u9ad8\u5171\u7ebf\u6027\uff08\u65b9\u5dee\u81a8\u80c0\u56e0\u5b50>10\uff09\u7684\u53d8\u91cf\u3002LAEF\u3001delta LASres\u548cLASres\u5177\u6709\u9ad8\u65b9\u5dee\u81a8\u80c0\u56e0\u5b50\uff0c\u56e0\u6b64delta LASres\u88ab\u6392\u9664\u5728\u9884\u6d4b\u6a21\u578b\u4e4b\u5916\u3002\u9996\u5148\u4f7f\u7528\u57fa\u7ebf\u65f6\u7684LA\u6d4b\u91cf\u8fdb\u884c\u4e24\u4e2a\u5355\u72ec\u7684\u591a\u53d8\u91cf\u5206\u6790\uff0c\u7136\u540e\u57283\u4e2a\u6708\u7684\u7a7a\u767d\u671f\u540e\u8fdb\u884c\u5206\u6790\uff0c\u4ee5\u786e\u5b9aAF\u590d\u53d1\u7684\u72ec\u7acb\u9884\u6d4b\u56e0\u5b50\u3002\u4e3a\u6bcf\u4e2a\u72ec\u7acb\u9884\u6d4b\u56e0\u5b50\u6784\u5efa\u53d7\u8bd5\u8005\u5de5\u4f5c\u7279\u5f81\u66f2\u7ebf\uff0c\u4ee5\u786e\u5b9a\u9884\u6d4bAF\u590d\u53d1\u7684\u6700\u4f73\u622a\u6b62\u503c\u3002\u7136\u540e\u4f7f\u7528\u4e34\u754c\u503c\u8fdb\u884cKaplan-Meier\u751f\u5b58\u66f2\u7ebf\u5206\u6790\uff0c\u4ee5\u663e\u793a\u968f\u8bbf\u671f\u95f4\u65e0AF\u5e76\u4f30\u8ba1\u8bca\u65ad\u51c6\u786e\u6027\u3002P<0.05\u88ab\u8ba4\u4e3a\u5177\u6709\u7edf\u8ba1\u5b66\u610f\u4e49\u3002<\/p>\n
\u7814\u7a76\u7ed3\u679c<\/p>\n
\u5728115\u540dCASA-AF\u53d7\u8bd5\u8005\u4e2d\uff0c32\u540d\u60a3\u8005\u88ab\u6392\u9664\u5728\u5916\uff0c\u5176\u4e2d7\u540d\u56fe\u50cf\u8d28\u91cf\u4e0d\u8db3\uff0c23\u540d\u57fa\u7ebf\u6216\u8fde\u7eed\u8d85\u58f0\u5fc3\u52a8\u56fe\u6570\u636e\u4e0d\u5b8c\u6574\uff0c2\u540d\u60a3\u8005\u5728AF\u9700\u8981\u91cd\u590d\u6d88\u878d\u3002\u57fa\u7ebf\u7279\u5f81\u4e0d\u53d7\u8fd9\u4e9b\u6392\u9664\u7684\u5f71\u54cd\u3002\u5728\u5176\u4f5983\u4f8b\u60a3\u8005\u4e2d\uff0c\u5e73\u5747\u5e74\u9f84\u4e3a63.6\uff08\u00b19.7\uff09\u5c81\uff0c73%\u4e3a\u7537\u6027\uff0c52%\u60a3\u6709\u9ad8\u8840\u538b\uff0c7%\u60a3\u6709\u7cd6\u5c3f\u75c5\uff0c13%\u60a3\u6709\u51a0\u72b6\u52a8\u8109\u75be\u75c5\uff0c7%\u662f\u5927\u91cf\u5438\u70df\u8005\uff0c4%\u65e2\u5f80\u6709\u8fc7\u4e2d\u98ce\u6216\u77ed\u6682\u6027\u8111\u7f3a\u8840\u53d1\u4f5c\uff0c6%\u60a3\u6709\u6162\u6027\u80be\u810f\u75be\u75c5\uff0c6%\u60a3\u6709\u7532\u72b6\u817a\u75be\u75c5\uff0c16%\u60a3\u6709\u547c\u5438\u9053\u75be\u75c5\u300237\u4f8b\u60a3\u8005\u63a5\u53d7\u5bfc\u7ba1\u6d88\u878d\u6cbb\u7597\uff0c83\u4f8b\u884c\u80f8\u8154\u955c\u624b\u672f\u6d88\u878d\u672f\u3002\u4e24\u79cd\u6d88\u878d\u7b56\u7565\u7684\u57fa\u7ebf\u4e34\u5e8a\u7279\u5f81\u6216\u5fc3\u623f\u98a4\u52a8\u590d\u53d1\u7387\u65e0\u663e\u8457\u5dee\u5f02\u3002\u572883\u4f8b\u60a3\u8005\u4e2d\uff0c53\u4f8b\uff0864%\uff09\u57283\u4e2a\u6708\u7684\u6d88\u9690\u671f\u540e\u51fa\u73b0\u9635\u53d1\u6027\u5fc3\u623f\u98a4\u52a8\u590d\u53d1\u3002<\/p>\n
\u88681\u3001\u7aa6\u5f8b\u7ec4\u4e0e\u623f\u98a4\u590d\u53d1\u7ec4\u57fa\u7ebf\u7279\u5f81\u6bd4\u8f83<\/p>\n
\u6d88\u878d\u672f\u5bfc\u81f4\u7684\u7aa6\u5f8b\u7ec4\u548c\u623f\u98a4\u590d\u53d1\u7ec4LA\u4f53\u79ef\u51cf\u5c11\u76f8\u4f3c\u3002\u7136\u800c\uff0c\u6d88\u878d\u672f\u540e3\u4e2a\u6708\u7aa6\u5f8b\u7ec4\u4e0eAF\u590d\u53d1\u7ec4\u76f8\u6bd4LA\u6392\u7a7a\u5206\u6570\uff083.10\u00b16.27% vs 9.9\u00b19.0%;P<001.22\uff09\u3001\u50a8\u5b58\u5e94\u53d8\uff086.8\u00b15.16% vs 7.5\u00b17.0%;P=001.9\uff09\u548c\u6536\u7f29\u5e94\u53d8\uff082.3\u00b14.5% vs 6.2\u00b15.0%;P<001.3\uff09\u66f4\u9ad8\u3002\u7aa6\u5f8b\u7ec4\u7684\u8212\u5f20\u529f\u80fd\u4f18\u4e8eAF\u590d\u53d1\u7ec4\uff0cE\/A\u6bd4\u4e3a1.5\u00b10.5 vs 2.2\u00b11.2\uff08P<2.0\uff09\uff0c\u5de6\u5fc3\u5ba4E\/e’\u6bd4\u503c\u5206\u522b\u4e3a001.8\u00b10.2\u548c1.10\u00b13.4\uff08P<1.0\uff09\u30023\u4e2a\u6708\u65f6\u7684LA\u6536\u7f29\u5e94\u53d8\u662fAF\u590d\u53d1\u7684\u552f\u4e00\u72ec\u7acb\u9884\u6d4b\u6307\u6807\u3002<\/p>\n
\u56fe3\u3001\u603b\u4f53\u4eba\u7fa4\u4e2d\uff0c\u5de6\u623f\u53c2\u6570\u7684\u53d8\u5316<\/p>\n
\u56fe4\u3001\u603b\u4f53\u4eba\u7fa4\u4e2d\uff0c\u5de6\u5fc3\u623f\u50a8\u5b58\u529f\u80fd \uff08LASres\uff09\u3001\u5bfc\u7ba1\u529f\u80fd \uff08LAScd\uff09 \u548c\u6536\u7f29\u529f\u80fd \uff08LASct\uff09 \u4ece\u57fa\u7ebf\u5230 12 \u4e2a\u6708\u7684\u53d8\u5316\u3002<\/p>\n
\u88682\u3001\u7aa6\u5f8b\u7ec4\u4e0e\u623f\u98a4\u7ec4\u590d\u53d1\u7ec4\u5de6\u5fc3\u623f\u5bb9\u79ef\u6570\u636e\u7684\u6bd4\u8f83<\/p>\n
\u88684\u3001\u7aa6\u6027\u5fc3\u5f8b\u4e0e\u5fc3\u623f\u98a4\u52a8\u590d\u53d1\u7ec4\u57fa\u7ebf\u65f6\u5de6\u5fc3\u5ba4\u6536\u7f29\u548c\u8212\u5f20\u529f\u80fd\u7684\u6bd4\u8f83\u53ca\u968f\u8bbf\u7ed3\u679c<\/p>\n
3\u4e2a\u6708\u968f\u8bbf\u6570\u636e\u7684\u5355\u53d8\u91cf\u5206\u6790\u663e\u793a\uff0cLAEF\u3001LASres\u3001LV e’\u548cLASct\u4e0e\u5fc3\u623f\u98a4\u52a8\u590d\u53d1\u5448\u8d1f\u76f8\u5173\u88685\u30023\u4e2a\u6708\u65f6\u8f83\u9ad8\u7684\u5de6\u5fc3\u5ba4E\/e’\u548cE\/A\u6bd4\u503c\u4e0e\u5fc3\u623f\u98a4\u52a8\u590d\u53d1\u6709\u5173\u3002\u591a\u53d8\u91cf\u5206\u6790\u663e\u793a\uff0cLASct \u964d\u4f4e\u662f AF \u590d\u53d1\u7684\u552f\u4e00\u72ec\u7acb\u9884\u6d4b\u6307\u6807\uff08\u98ce\u9669\u6bd4\uff0c0.69 [95% CI\uff0c0.49\u20130.98];P=0.04\uff09\u3002\u5c06\u591a\u53d8\u91cf\u6a21\u578b\u4e2d\u76843\u4e2a\u6708LAEF\u548cLASres\u6570\u636e\u66ff\u6362\u4e3adelta LAEF\u548cdelta LASres\u4e0d\u5f71\u54cd\u8fd9\u4e00\u53d1\u73b0\u3002<\/p>\n
\u88685\u3001\u57fa\u7ebf\u548c\u5c04\u9891\u6d88\u878d\u672f\u540e\u76f8\u5173\u53d8\u91cf\u7684\u5355\u53d8\u91cf\u548c\u591a\u53d8\u91cfCox\u56de\u5f52\u5206\u6790\uff0c\u7528\u4e8e\u9884\u6d4b\u968f\u8bbf\u671f\u95f4\u5fc3\u623f\u98a4\u52a8\u590d\u53d1<\/p>\n
\u57fa\u7ebf\u53c2\u6570\u7684\u5355\u53d8\u91cf\u5206\u6790\u663e\u793a\uff0cLA\u7403\u5f62\u5ea6\u6307\u6570\u548c\u51a0\u72b6\u52a8\u8109\u75be\u75c5\u4e0eAF\u590d\u53d1\u8d8b\u52bf\u76f8\u5173\u3002\u7136\u800c\uff0c\u7531\u4e8e\u5b83\u4ec5\u5b58\u5728\u4e8e10\u540d\u60a3\u8005\u4e2d\uff0c\u5360\u6837\u672c\u768413%\uff0c\u56e0\u6b64\u672a\u5305\u542b\u5728\u591a\u53d8\u91cf\u6a21\u578b\u4e2d\u30023\u4e2a\u6708\u968f\u8bbf\u65f6LASct\u7684\u53d7\u8bd5\u8005\u5de5\u4f5c\u7279\u5f81\u66f2\u7ebf\u5206\u6790\u5982\u56fe5\u663e\u793aAF\u590d\u53d1\u7684\u5f3a\u9884\u6d4b\u503c\uff0c\u66f2\u7ebf\u4e0b\u9762\u79ef\u4e3a0.83\uff08P<0.001\uff09\uff0c\u6700\u4f73\u4e34\u754c\u503c\u4e3a7.7%\uff08\u654f\u611f\u6027=62%\uff0c\u7279\u5f02\u6027=85%;\u9633\u6027\u9884\u6d4b\u503c=71%\uff0c\u9634\u6027\u9884\u6d4b\u503c=82%\uff09\u3002\u5982\u56fe6\u6240\u793a\uff0cLASct \u503c\u4e3a >7.7% \u4e0e 70.8% \u7684\u5fc3\u623f\u98a4\u52a8\u76f8\u5173\uff0c\u800c <7.7% \u7684\u503c\u4e0e 18.8% \u7684\u5fc3\u623f\u98a4\u52a8\u76f8\u5173\uff08\u98ce\u9669\u6bd4\uff0c4.2 [95% CI\uff0c1.84\u20139.4];P=0.001\uff09\u3002<\/p>\n
\u56fe5\u30013\u4e2a\u6708\u65f6\u5de6\u5fc3\u623f\u6536\u7f29\u5e94\u53d8\u7684\u53d7\u8bd5\u8005\u5de5\u4f5c\u7279\u5f81\uff08ROC\uff09\u66f2\u7ebf\u7528\u4e8e\u9884\u6d4b\u5fc3\u623f\u98a4\u52a8\u590d\u53d1\u3002<\/p>\n
\u56fe6\u3001Kaplan-Meier \u751f\u5b58\u66f2\u7ebf\u3002\u57fa\u4e8e\u968f\u8bbf\u4e2d\u6d4b\u91cf\u7684\u5de6\u5fc3\u623f\u6536\u7f29\u5e94\u53d8 \uff08LASct\uff097.7%\u63d0\u793a\u5fc3\u623f\u98a4\u52a8\u7684\u590d\u53d1\u3002<\/p>\n
\u7814\u7a76\u7ed3\u8bba<\/p>\n
AF \u6d88\u878d\u672f\u540e LSPAF \u4e2d\u7684 LA \u529f\u80fd\u5f97\u5230\u6539\u5584\uff0c\u8868\u73b0\u4e3a LA \u4f53\u79ef\u51cf\u5c11\u3001LAEF \u6539\u5584\u3001\u50a8\u5b58\u529f\u80fd\u6539\u5584\u548c\u5fc3\u623f\u6536\u7f29\u6062\u590d\u3002\u6d88\u9690\u671f\u540e LASct \u964d\u4f4e\u662f AF \u590d\u53d1\u7684\u552f\u4e00\u72ec\u7acb\u9884\u6d4b\u6307\u6807\u3002\u672a\u6765\u9700\u8981\u8fdb\u4e00\u6b65\u7814\u7a76\u6765\u8bc4\u4ef7\u6d88\u878d\u7ed3\u5c40\uff0c\u4e0d\u4ec5\u57fa\u4e8eLA\u7ed3\u6784\uff0c\u8fd8\u57fa\u4e8eLA\u529f\u80fd\uff0c\u7279\u522b\u662fLASct\uff0c\u8fd9\u53ef\u80fd\u4f1a\u6709\u5229\u4e8e\u6d88\u878d\u6210\u529f\u7387\u7684\u63d0\u9ad8\u3002<\/p>\n<\/p>\n
\u5fc3\u8bed\u70b9\u8bc4<\/p>\n
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Khan HR, Yakupoglu HY, Kralj-Hans I, Haldar S, Bahrami T, Clague J, De Souza A, Hussain W, Jarman J, Jones DG, Salukhe T, Markides V, Gupta D, Khattar R, Wong T; CASA AF Investigators. Left Atrial Function Predicts Atrial Arrhythmia Recurrence Following Ablation of Long-Standing Persistent Atrial Fibrillation. Circ Cardiovasc Imaging. 2023 Jun;16(6):e015352.<\/p>\n<\/p>\n
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