频发房性早搏对凝血功能及心房—肺静脉纤维化的影响  

Effects of frequent premature atrial contraction on coagulation function and atrium-pulmonary vein fibrosis

作　　者：张棠[1] 刘浩[1] 黄焕杰 梁东艳 关耀宗 卢德生 梁秀媛 Zhang Tang;Liu Hao;Huang Huanjie;Liang Dongyan;Guan Yaozong;Lu Desheng;Liang Xiuyuan(Department of Cardiology,The Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学第二附属医院心内科,南宁530007

出　　处：《广西医科大学学报》2022年第10期1556-1562,共7页Journal of Guangxi Medical University

基　　金：广西自然科学基金资助项目(No.2019GXNSFAA245099)。

摘　　要：目的:探讨频发房性早搏对凝血功能及心房—肺静脉纤维化的影响。方法:将健康成年中华田园犬12只随机分为模型组和对照组,每组6只。模型组通过左心耳植入永久性心脏起搏器,构建频发房性早搏模型并持续以房性早搏二联律起搏;对照组以相同方式植入起搏器但未起搏。分别于术前及术后6个月采用酶联免疫吸附(ELISA)法测定血浆中凝血因子Ⅻ(FⅫ)、D-二聚体(D-D)水平以及活化的凝血酶原时间(APTT);术后6个月取左心房和肺静脉通过ELISA测定转化生长因子β1(TGF-β1)和Ⅲ型胶原蛋白(CoI-Ⅲ)含量;Masson染色观察纤维化程度。结果:对照组和模型组术前FⅫ、APTT和D-D水平比较,差异无统计学意义(均P>0.05)。术后6个月,模型组的D-D水平高于对照组(P<0.05),FⅫ、APTT无统计学差异(均P>0.05);模型组左肺静脉TGF-β1和CoI-Ⅲ含量高于对照组,右肺静脉CoI-Ⅲ含量高于对照组(P<0.05);Masson染色中模型组左、右肺静脉的胶原纤维含量均高于对照组(P<0.05);左心房的胶原纤维含量与对照组比较无统计学差异(P>0.05)。结论:频发房性早搏可能是促进凝血和心房—肺静脉纤维化形成的潜在因素。Objective:To investigate the effects of frequent premature atrial beats on coagulation and atrium-pulmonary venous fibrosis.Methods:Twelve healthy adult Chinese rural dogs were randomly divided into a model group and a control group,with 6 dogs in each group.In the model group,a permanent pacemaker was implanted in the left auricle to construct a model of frequent premature atrial contraction and cause continual atrial bigeminy;in the control group,a pacemaker was implanted in the same way but not pacing the heart.Serum levels of coagulation factorⅫ(FⅫ),D-dimer(D-D)and activated partial thromboplastin time(APTT)were measured by enzyme-linked immunosorbent assay(ELISA)before and 6 months after surgery,respectively;the levels of transforming growth factorβ1(TGF-β1)and collagen typeⅢ(CoI-Ⅲ)in the left atrium and pulmonary veins at 6 months after surgery were measured by ELISA;Masson staining was performed to observe the degree of fibrosis.Results:There was no statistically significant difference in the preoperative FⅫ,APTT and D-D levels between the control and model groups(all P>0.05).At 6 months after surgery,the D-D levels in the model group were higher than those in the control group(P<0.05),and there was no statistical difference in FⅫand APTT(both P>0.05);the TGF-β1 and CoI-Ⅲlevels in the left pulmonary veins were higher in the model group than those in the control group,and the CoI-Ⅲlevels in the right pulmonary veins were higher in the model group than those in the control group(P<0.05);the collagen fiber content of both left and right pulmonary veins in Masson staining was higher in the model group than that in the control group(P<0.05);the difference in the collagen fiber content of the left atrium was not statistically significant(P>0.05).Conclusion:Frequent premature atrial contraction may be a potential factor promoting the formation of coagulation and atrium-pulmonary vein fibrosis.

关 键 词：房性早搏 凝血因子Ⅻ D-二聚体 活化的部分凝血酶原时间 纤维化 

分 类 号：R541.7[医药卫生—心血管疾病]