特发性房颤患者内皮功能指标变化及其与血小板功能的相关关系  

Changes of endothelial function indices and their relation to platelet activation in idiopathic atrial fibrillation

作　　者：傅锐斌[1,2,3] 吴平生[4] 吴书林[2,3] 邱健[1] 

机构地区：[1]广州军区广州总医院心内科 [2]广东省心血管病研究所,广东广州510100 [3]广东省人民医院,广东广州510100 [4]第一军医大学附属南方医院心内科

出　　处：《南方医科大学学报》2010年第4期771-773,共3页Journal of Southern Medical University

基　　金：广东省科技计划项目(2008A030201030)

摘　　要：目的研究特发性房颤内皮功能指标变化及其与血小板功能的关系。方法入选特发性房颤的患者和年龄、性别因素匹配的健康对照个体,测定其血小板计数,并采用Griess法测定血浆硝酸盐/亚硝酸盐(NOx),采用ELISA法测定血浆血管性假血友病性因子(vWF)和可溶性P-选择素(sP-selectin)水平,比较两组间这些指标差异,分析内皮功能指标和血小板激活指标之间的相关关系。结果特发性房颤和对照组的血小板计数分别为(220.5×109±82.1×109)和(236.0×109±36.0×109)109/L(P=0.282),血浆NOx水平分别为(18.2±7.3)和(24.3±7.8)μmol/L(P=0.049),血浆vWF水平分别为(112.9±36.8)%和(106.1±34.3)%(P=0.404),血浆sP-selectin水平分别为(25.6±6.2)和(22.4±4.8)ng/ml(P=0.007)。相关分析结果显示,特发性房颤患者血浆NOx水平与sP-selectin水平之间呈显著负相关(r=-0.405,P=0.025)。特发性房颤患者血一氧化氮(NO)水平显著降低,sP-selectin水平显著增高,NO水平与sP-selectin呈显著性负相关。结论房颤本身可能导致内皮功能减退和血小板功能激活,内皮功能减退可能为引起房颤血小板功能激活的原因。Objective To investigate the changes of endothelial function indices and their relation to platelet activation in patients with idiopathic atrial fibrillation （AF）.Methods We studied 61 patients with idiopathic AF with 34 age- and sex-matched healthy persons as control.Platelet counts in the blood were tested,and plasma levels of NOx were analyzed using Griess method.The plasma levels of von Willibrand factor （vWF） and soluble P-selectin （sP-selectin） were determined using enzyme-linked immunosorbent assay.Results Compared to healthy control,the patients with idiopathic AF had significantly lower levels of plasma NOx （18.2±7.3 vs 24.3±7.8 μmol/L,P=0.049） and higher levels of plasma sP-selectin （25.6±6.2 vs 22.4±4.8 ng/ml,P=0.007）.No significant differences were found in the platelet counts or plasma vWF levels between the two groups.A significant inverse correlation was found between plasma NOx and sP-selectin （r=-0.405,P=0.025） in patients with idiopathic AF.Conclusion AF per se may impair the endothelial function and activate platelet function,suggesting the role of endothelial dysfunction in activated platelet function in AF patients.

关 键 词：特发性房颤 一氧化氮 可溶性P选择素 

分 类 号：R541.75[医药卫生—心血管疾病]