性别对行左心耳封堵术的心房颤动患者预后的影响

刘力萍; 许祥; 万陈; 刘锋; 姚青; 王斌斌; 颜文; 宋玲; 宋治远; 李华康

doi:10.16016/j.2097-0927.202311122

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性别对行左心耳封堵术的心房颤动患者预后的影响

临床医学 | 更新时间：2026-01-09

- 性别对行左心耳封堵术的心房颤动患者预后的影响
- Influence of gender on prognosis of atrial fibrillation patients after left atrial appendage occlusion
- 陆军军医大学学报 2024年46卷第15期页码：1797-1802
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院心血管内科
- 作者简介：
  
  [李华康, E-mail: lihuakang1980@163.com LI Huakang, E-mail: lihuakang1980@163.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202311122
  中图分类号： R181.32;R540.46;R541.75
- 收稿：2023-11-26，
  
  修回：2024-03-02，
  
  纸质出版：2024-08-15
- 稿件说明：
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刘力萍, 许祥, 万陈, 等. 性别对行左心耳封堵术的心房颤动患者预后的影响[J]. 陆军军医大学学报, 2024,46(15):1797-1802.

Liping LIU, Xiang XU, Chen WAN, et al. Influence of gender on prognosis of atrial fibrillation patients after left atrial appendage occlusion[J]. Journal of Army Medical University, 2024, 46(15): 1797-1802.
刘力萍, 许祥, 万陈, 等. 性别对行左心耳封堵术的心房颤动患者预后的影响[J]. 陆军军医大学学报, 2024,46(15):1797-1802. DOI： 10.16016/j.2097-0927.202311122.

Liping LIU, Xiang XU, Chen WAN, et al. Influence of gender on prognosis of atrial fibrillation patients after left atrial appendage occlusion[J]. Journal of Army Medical University, 2024, 46(15): 1797-1802. DOI： 10.16016/j.2097-0927.202311122.

摘要

目的

探讨性别对心房颤动患者行经皮左心耳封堵术预后的影响。

方法

选择2014年8月至2021年8月在我院住院并行左心耳封堵术的非瓣膜性心房颤动患者为研究对象，根据性别分组，收集患者的资料，包括性别、年龄、合并的基础疾病、经胸超声心动图和经食道超声心动图(transesophageal echocardiography

TEE)等结果，随访患者术后出现器械相关血栓(device related thrombosis

DRT)、心包填塞、卒中、出血、心衰住院、心源性死亡等情况，比较性别对心房颤动患者行左心耳封堵术预后的影响。

结果

共673例非瓣膜性心房颤动患者入选本研究，其中男性366例，女性307例，年龄(68.2±9.4)岁，女性患者CHA

-VASc评分高于男性(

0.01)，男性患者既往卒中比例、封堵器平均压缩率及封堵后残余分流(

3 mm)发生率高于女性(

0.05)；术后45~60 d复查TEE发现DRT有17例，其中男性8例(2.2%)，女性9例(2.9%)，两组比较差异无统计学意义。DRT中有1例发生卒中，合并与不合并DRT卒中发生率为5.9%和0.5%。术后发生心包填塞4例，其中男性组1例，女性组3例，均予以心包穿刺抽液后好转，两者发生率差异无统计学意义。随访(40.2±20.5)个月，随访期内2组患者在卒中、出血、心衰住院、心源性死亡方面差异无统计学意义。

结论

性别对非瓣膜性心房颤动患者行左心耳封堵术后的预后无显著影响。

Abstract

Objective

To explore the influence of gender on the prognosis of patients with atrial fibrillation (AF) undergoing left atrial appendage occlusion (LAAO).

Methods

All non-valvular AF patients who were admitted in our hospital and underwent LAAO from August 2014 to August 2021 were enrolled and grouped according to gender. Their general information

including gender

age

comorbid underlying diseases

and results of transthoracic echocardiography and transesophageal echocardiography (TEE) were collected. The incidences of device-related thrombosis (DRT)

pericardial tamponade

stroke

bleeding

hospitalization for heart failure

and cardiac death were recorded during follow-up. The influence of gender on the prognosis of these patients was analyzed.

Results

There were totally 673 patients with non-valvular AF were enrolled

including 366 males and 307 females

at a mean age of 68.2±9.4 years. When compared with the male patients

the female ones had a higher CHA2DS2-VASc score (

0.01)

but smaller proportions of history of stroke

average compression ratio of occluders

and incidence of residual shunt (

3 mm) after occlusion (

0.05). In 45~60 d after surgery

TEE revealed that there were 17 cases of DRT

including 8 males (2.2%) and 9 females (2.9%)

though without statistical difference between the groups. Among the 17 DRT cases

1 experienced stroke

and the incidence of stroke was 5.9% in those with DRT and 0.5% without. There were 4 cases of postoperative pericardial tamponade

including 1 in the male group and 3 in the female group (no significant difference)

and all of them were improved after pericardial puncture and fluid extraction. During the follow-up period of 40.2±20.5 months

no obvious differences were observed between the 2 groups in terms of stroke

bleeding

hospitalization for heart failure

and cardiogenic death.

Conclusion

Gender shows no significant effect on the prognosis of patients with non-valvular AF after LAAO.

关键词

Keywords

references

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