NHR联合心脏超声参数对非瓣膜性房颤患者左心耳血栓形成的临床价值评估
Predictive Value of the Neutrophil-to-High-Density Lipoprotein Ratio Combined with Echocardiographic Parameters for Left Atrial Appendage Thrombosis in Patients with Non-Valvular Atrial Fibrillation
DOI: 10.12677/jcpm.2026.53194, PDF,    科研立项经费支持
作者: 杜吉雅：内蒙古科技大学包头医学院研究生院，内蒙古 包头；陈 华*：内蒙古自治区人民医院心血管内科，内蒙古 呼和浩特
关键词: 左心房内径；左心室射血分数；中性粒细胞与高密度脂蛋白胆固醇比值；左心耳血栓形成；CHA2DS2-VASc评分；Left Atrial Diameter； Left Ventricular Ejection Fraction； Neutrophil to High-Density Lipoprotein Cholesterol Ratio； Left Atrial Appendage Thrombosis； CHA2DS2-VASc Score
摘要: 目的：探讨中性粒细胞/高密度脂蛋白联合心脏超声参数筛查非瓣膜性房颤患者左心耳血栓中的价值。方法：选取193例NVAF患者，根据经食管超声结果分为无血栓组(115例)与血栓组(78例)，比较两组临床资料、血清学及超声参数差异，采用多因素Logistic回归分析独立影响因素，并通过ROC曲线评估各指标及其组合的筛查效能。结果：左房内径增大、CHA2DS2-VASc评分增高、中性粒细胞与高密度脂蛋白胆固醇比值升高为独立危险因素，左心室射血分数与白蛋白为保护因素(均P < 0.05)。中性粒细胞与高密度脂蛋白胆固醇比值联合左心室射血分数、左心房内径的AUC为0.926，优于单一CHA2DS2-VASc评分(AUC = 0.783)。结论：中性粒细胞与高密度脂蛋白胆固醇比值联合心脏超声参数左心室射血分数、左心房内径对筛查非瓣膜性房颤患者左心耳血栓形成风险具有较高价值。
Abstract: Objective: To investigate the value of neutrophil-to-high-density lipoprotein ratio combined with echocardiographic parameters in screening for left atrial appendage thrombosis in patients with non-valvular atrial fibrillation. Methods: A total of 193 patients with NVAF were enrolled and divided into a non-thrombus group (115 cases) and a thrombus group (78 cases) based on transesophageal echocardiography results. Clinical data, serological markers, and echocardiographic parameters were compared between the two groups. Multivariate logistic regression analysis was used to identify independent influencing factors, and receiver operating characteristic curve analysis was performed to evaluate the screening efficacy of individual indicators and their combinations. Results: Increased left atrial diameter, elevated CHA2DS2-VASc score, and a higher neutrophil-to-high-density lipoprotein cholesterol ratio were identified as independent risk factors, while left ventricular ejection fraction and albumin were protective factors (all P < 0.05). The combination of neutrophil-to-high-density lipoprotein cholesterol ratio with left ventricular ejection fraction and left atrial diameter yielded an area under the curve of 0.926, which was superior to that of the CHA2DS2-VASc score alone (AUC = 0.783). Conclusion: The combination of neutrophil-to-high-density lipoprotein cholesterol ratio with echocardiographic parameters, including left ventricular ejection fraction and left atrial diameter, demonstrates high value in screening for the risk of left atrial appendage thrombosis in patients with non-valvular atrial fibrillation.
文章引用：杜吉雅, 陈华. NHR联合心脏超声参数对非瓣膜性房颤患者左心耳血栓形成的临床价值评估[J]. 临床个性化医学, 2026, 5(3): 151-161. https://doi.org/10.12677/jcpm.2026.53194

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