非瓣膜性心房颤凝血-纤溶系统活性改变研究

Study on Hypercoagulation and Hypofibrinolysis State in Atrial Fibrillation.

目的心房纤颤凝血-纤溶系统改变及其意义。方法为选择慢性非瓣膜性心房纤颤患者(AF 组)54例(男28例,女26例,年龄58.4±12.3岁),并入选与以上非瓣膜性心房纤颤病人存在相同心血管疾病(高血压或冠心病)的窦性心律者(SR 组)40例(男20例,女20例,年龄57.6±11.7岁)及健康体检者35例为对照组(C 组)(男17例,女18例,年龄52.4±18.5岁)。测定以上三组患者血浆纤维蛋白原(FIB)、D-二聚体(D-D)、组织纤溶酶原激活剂(tPA)和组织纤溶酶原抑制剂(PAI)浓度,及凝血酶原时间(PT)、凝血酶时间(TT)和部分凝血活酶时间(APTT)。结果提示非瓣膜性心房纤颤患者血浆 FIB、D-D 和 PAI 显著升高,tPA 显著降低。PT、TT 和 APTT 则无显著变化。结论非瓣膜性心房纤颤患者存在高凝和低纤溶状态。

Objective To study the change of coagulation and fibrinolysis system and its clinical significance in atrial fibrillation.Methods We performed a study in 54 chronic nonvalvular atrial fibrillation(NVAF)patients(AF group,28 men and 26 women,aged 58.4±12.3 yeats),40 sinus rhythm patients with the same cardiovascular history as NVAF patients(SR group,20 men and 20 women,aged 57.6±11.7 years),and 35 matched healthy control subjects in sinus rhythm(C group,17 men and 18 women,aged 52.4±18.5 yeats).Plasma levels of fibrinogen(FIB),fib- rin d-dimer(D-D),tissue plasminogen activator(tPA),its inhibitor(PAI),prothrombin time(PT),thrombin time(TT)and activated part throm- boplastin time(APIT)were measured in plasma from each groups above.Results Patients with chronic NVAF had higher plasma FIB,D-D and PAI levels as compared with SR group and C group,While tPA was lower in AF group than the others.There was no significant differences in PT, TT and APTT in the three groups.Conclusion There is a hypercoagulation and hypofibrinolysis state in chronic nonvalvular atrial fibrillation pa- tients.