老年人扩张型心肌病并房颤患者血栓前状态研究  

Study of the Prethrombotic State of Senile Patient with Idiopathic Dilated Cardiomyopathy

作　　者：赖沙毅[1] 陈维芊[1] 吕桂芬[1] 

机构地区：[1]广西医科大学第四附属医院心内科,广西柳州545005

出　　处：《华夏医学》2004年第1期12-14,共3页Acta Medicinae Sinica

摘　　要：目的 :了解老年人扩张型心肌病 (DCM)并房颤 (AF)患者血栓前状态。方法 :对 5 4例老年扩张型心肌病患者 (其中并房颤 33例 ,非房颤 2 1例 )的血清进行 t- PA、PA - 1、v WF、GMP- 1 4 0、AT- 检测 ,同时 ,通过超声心动图检查了解这些患者的心内结构、心内血栓、心功能 ,与 1 9例正常人对照。并对 5 4例患者的血栓形成事件进行随访。结果 :DCM非 Af患者与正常人相比 GMP- 1 4 0升高 (P<0 .0 1 ) ,DCM并 AF患者与正常人相比 v WF、GMP- 1 4 0升高 (P<0 .0 1 ) ,与正常人相比 DCM患者 L V、L A均增大 (P<0 .0 1 ) ,EF值降低 (P<0 .0 1 ) ,DCM+AF患者与 DCM非 AF患者相比 L A增大明显 (P<0 .0 1 )。结论 :老年 DCM患者存在 PTS,以血小板活性增强为主 ,如合并有 AF则同时伴有心脏内皮细胞受损 ;提示临床抗血小板、维护心脏内皮细胞功能治疗对减少老年Objective:To study the prethrombotic state of senile patient with idiopathic dilated cardiomyopathy (DCM)with atrial fibrillation(AF).Methods:The serum concentration of t PA,PAI 1,vWF,GMP 140 and AT Ⅲ of 54 cases of senile patients with DCM(including 33 cases of patients with AF and 21 cases without AF)was detected.The intracardial structure,intracardial thrombus and cardiac function were studied with ultrasonic cardiogram.All patients were followed for thrombosis event.Results:The serum level of GMP 140 in patients with DCM without AF was significantly higher than that in healthy control(P<0 01).The serum level of vWF and GMP 140 in patients with DCM with AF was significantly increased compared with that in healthy control(P<0.01).Compared with that of healthy control,Both left ventricular and left atrium(LA)got enlarged,But EF decreased in patients with DCM (P<0.01).Furthermore,LA of patients with DCM with AF got enlarged markedly compared with that of patients with DCM without AF(P<0.01).Conclusions:PTS exists in senile patient with DCM,mainly characterized by the up regulation of activation of thrombocyte,the injury of cardiac endothelial cell will occur if there is AF at the same time.It indicates that depressing the activation of thrombocyte and maintenance of the function of cardiac endothelial cell is important in decreasing the incidence of thrombosis.

关 键 词：扩张型心肌病 心房纤颤 血栓前状态 

分 类 号：R542.2[医药卫生—心血管疾病]