风湿性心脏病血栓形成机制的临床研究——附242例检测报告  

Mechanism and diagnosis of thrombosis in rheumatic heart disease

作　　者：袁奇[1] 吴竞生 单凤仙[1] 黄向阳[1] 蒋玉霞[1] 汪健[1] 

机构地区：[1]安徽省立医院,230001

出　　处：《新医学》1999年第8期451-452,共2页Journal of New Medicine

基　　金：安徽省卫生厅资助

摘　　要：目的 :探讨风湿性心脏病 (风心病 )血栓前状态及血栓形成机制 ,各因素的作用及其相互关系。方法 :经食管超声心动描记术 ( TEE)检查风心病患者 2 4 2例 ,确定心腔内云雾状回声、血栓形成、左心房增大情况。同时检测 2 0例云雾状回声患者、2 0例血栓形成患者和 2 0名正常人的血液血管性血友病因子相关抗原 ( v WF:Ag)、血小板激活标记物 -血小板α颗粒膜蛋白 ( GMP- 14 0 )、抗凝血酶 活性 ( AT- :C)、D-二聚体 ( D- Dimer)水平。结果 :风心病患者 93 .8%发现云雾状回声 ,血栓形成 3 3 .5 % ;其中心房颤动者与窦性心律者比较血栓形成差异有显著性 ( P<0 .0 0 1)。血液学指标 :v WF:Ag、GMP- 14 0、AT- :C、D-二聚体 ,云雾状回声组、血栓组与正常组比较均有显著性差异 ( P<0 .0 0 1) ,云雾状回声组与血栓组之间差异示有显著性。结论 :TEE是发现云雾状回声和血栓形成的最有效方法 。Objective:To investigate how to diagnose pre thrombosis state and what is the mechanism of thrombosis in rheumatic heart disease(RHD) Methods:242 RHD patients were examined with transesophageal echocardiography(TEE) to identify intra cardiac cloudy echo (CE),thrombosis,and left atrial enlargement Endo thelin level, platelet function,coagulation and anticoagulation activities,and fibrinolysis were measured in 20 CE patients,20 patients with thrombosis and in 20 normal subjects Results:93 8% RHD patients were found to have SEC and 33 5% patients,to have thrombosis Patients with atrial fibrillation had thrombosis more frequently than those patients with sinus rhythm( P <0 001) Hematologic indices such as vWF Ag,GMP 140,AT Ⅲ:C and D Dimer level were significantly different from those in two groups( P <0 001) Conclusion:TEE in an effective method to identify CE and thrombosis Hematological indicies may be useful for early diagnosis of pre thrombosis state and thrombosis

关 键 词：风湿性心脏病 血栓形成 超声心动图 

分 类 号：R541.204[医药卫生—心血管疾病] R540.45[医药卫生—内科学]