风湿性二尖瓣狭窄伴心房颤动患者血栓前状态的研究  

Study on prothrombotic state in patients with rheumatic mitral stenosis and atrial fibrillation

作　　者：刘应才[1] 欧阳迎春[1] 黄维义[1] 苑冀荣[2] 邓正华[2] 罗兴林[1] 

机构地区：[1]泸州医学院附属医院心内科,四川泸州646000 [2]泸州医学院附属医院检验科

出　　处：《临床心血管病杂志》2002年第5期220-222,共3页Journal of Clinical Cardiology

摘　　要：目的 :观察风湿性二尖瓣狭窄伴心房颤动 (房颤 )的血栓前状态。方法 :使用酶联免疫法和凝固法测量 2 4例风湿性心脏病 (风心病 )伴窦性心律患者 (窦律组 )、2 5例风心病伴房颤患者 (房颤组 )和 2 0例对照者 (对照组 )的外周血浆因子Ⅷ相关抗原 (VWFAg)、血小板α颗粒膜蛋白 14 0 (GMP 14 0 )、D 二聚体 (D dimer)和纤维蛋白原 (Fg)的水平变化 ,进行统计学分析。 结果 :与对照组比 ,窦律组血浆VWFAg、D dimer和Fg水平均显著升高(P <0 .0 5 ) ,而血浆GMP 14 0水平无显著性改变 (P >0 .0 5 ) ;房颤组血浆GMP 14 0、D dimer和Fg水平也明显升高 (P <0 .0 5 )。房颤组与窦律组相比血浆GMP 14 0、VWFAg、D dimer水平更高 (P <0 .0 5 ) ,而Fg水平在二者之间无明显变化 (P >0 .0 5 )。结论 :风湿性二尖瓣狭窄伴房颤患者外周血存在血栓前状态。Objective:To observe prothrombotic state in patients with rheumatic mitral stenosis and atrial fibrillation (Af).Method: Levels of von willebrand factor antigen (VWF Ag), platelet alpha granule membrane protein 140 (GMP 140), fibrin D dimer (D dimer) and fibrinogen (Fg) were measured in peripheral plasma from 49 patients with rheumatic mitral stenosis or 22 healthy subjects using ELISA. These patients were divided into sinus rhythm (SR) group and Af group.Result: Compared with control, patients with SR or Af had higher plasma levels of VWF Ag. D dimer and Fg(P< 0.05 ). Increased GMP 140 level was not found in patients with SR (P> 0.05 ) but in patients with Af (P< 0.05 ). Compared with SR group, Af group had higher plasma levels of GMP 140, VWF Ag and D dimer (P< 0.05 ).Conclusion: Atrial fibrillation secondary to mitral stenosis confers prothrombotic state.

关 键 词：风湿性二尖瓣狭窄 心房颤动 血栓前状态 

分 类 号：R542.5[医药卫生—心血管疾病] R541.75[医药卫生—内科学]