| 徐建辉,李朋,杨海珍,等.外周血 CD64指数对非瓣膜性心房颤动病人左心房血栓形成的预测价值[J].安徽医药,2020,24(2):304-307. |
| 外周血 CD64指数对非瓣膜性心房颤动病人左心房血栓形成的预测价值 |
| The predictive value of CD64 index in peripheral blood in non? valvular atrial fibrillation patients with left atrial thrombus |
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| DOI：10.3969/j.issn.1009?6469.2020.02.023 |
| 中文关键词: 心房颤动 血栓形成 心房 超声心动描记术，经食管 中性白细胞 受体， IgG 流式细胞术 CD64指数 非瓣膜性心房颤动 CHADS2评分 CHA2DS2?VASc评分 |
| 英文关键词: Atrial fibrillation Thrombosis Heart atria Echocardiography,transesophageal Neutrophils Receptors,IgG Flow cytometry CD64 index Non?valvular atrial fibrillation CHADS2 score CHA2DS2?VASc score |
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| 目的探讨外周血 CD64指数对非瓣膜性心房颤动( Non?Valvular Atrial fibrillation，NVAF)病人左心房血栓形成的预测价值。方法选取 2014年 1月至 2018年 1月于武汉科技大学附属孝感医院收治的怀疑存在左心房血栓的 NVAF病人 280例作为研究对象，根据食管心脏超声( TEE)检查结果，分为血栓组( 53例)和非血栓组( 227例)。记录两组病人一般临床资料及相关实验室检查等指标，分析 NVAF病人左心房血栓形成的独立危险因素，绘制受试者工作曲线( ROC)分析外周血 CD64指数对 NVAF病人左心房血栓形成的预测价值。结果血栓组病人外周血 CD64指数显著高于非血栓组病人，差异有统计学意义( P＜0.05)。多因素 logistic回归分析显示，房颤病程、卒中风险评分( CHADS2评分、 CHA2DS2?VASc评分)及 CD64指数是病人左心房血栓形成的独立危险因素；相关性分析显示，血栓组病人 CD64指数水平与 CHADS2评分、 CHA2DS2?VASc评分呈正相关(CHADS2评分: r＝0.930，P＜0.0001；CHA2DS2?VASc评分: r＝0.920，P＜0.0001)。 ROC曲线分析显示，外周血 CD64指数曲线下面积为 0.852(95%CI:0.736~0.932)其最佳工作点为 6.3，此时预测左心房血栓形成的灵敏度和特异度分别为 84.8%和 85.3%。结论外周血 CD64指数在 NVAF并发，左心房血栓形成的病人中明显升高，其可作为左心房血栓形成的独立危险因素，对于评估 NVAF并发左心房血栓形成，具有的一定的临床运用价值。 |
| 英文摘要: |
| Objective To evaluate the predictive value of CD64 index in peripheral blood on left atrial thrombus in patients with non?valvular atrial fibrillation(NVAF).Methods 280 patients with NVAF suspected with left atrial thrombus who were admitted to Xiaogan Hospital Afiliated to Wuhan University of Science and Technology from January 2014 to January 2018 were enrolled.Ac?cording to the results of transesophageal echocardiography examination(TEE)，these patients were divided into the thrombus group(53 cases)and non?thrombus group(227 cases).The clinical data and related laboratory examination of the patients were record? ed，the independent risk factors of left atrial thrombosis were analyzed by logistic regression，and the predictive value of CD64 in?dex in peripheral blood on left atrial thrombosis in NVAF patients were assessed by receiver operator characteristic curve(ROC). Results The level of CD64 index in peripheral blood were significantly higher in thrombus group than that in non?thrombus group group(P＜0.05)，the difference was statistically significant(P＜0.05)； The multivariate logistic regression analysis showed that atrial fibrillation，CHADS2 score，CHA2DS2?VASc score，CD64 index were independent risk factor for left atrial thrombosis in pa?tients.The correlation analsis showed that CD64 index in thrombosis group were positively correlated with CHADS2 and CHADS2? VASc score(CHADS2 score:r＝0.930，P＜0.0001；CHADS2?VASc score:r＝0.920，P＜0.0001).ROC curve analysis showed that the area under curve of CD64 index level was 0.852(95%CI 0.736~0.932)，and optimal operating point(OOP)was 6.3，which had 84.8% sensiticity and 85.3% specificity.Conclusion The CD64 index in peripheral boood was significantly increased in pa? tients with NVAF complicated with left atrial thrombosis，which could be used as an independent risk factor for left atrial thrombo?sis.The CD64 index in peripheral boood could effectively predict the occurrence of NVAF complicated with left atrial thrombosis， which has certain clinical application value. |
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