非瓣膜性心房颤动患者凝血—纤溶系统活性的变化及临床意义

Study on the State of Coagulation and Fibrinolysis System in Patients With Chronic Non-Valvular Atrial Fibrillation

目的 :探讨非瓣膜性心房颤动患者凝血—纤溶系统改变及其意义。 方法 :选择慢性非瓣膜性心房颤动患者 (心房颤动组 ) 5 4例 ,其中男 2 8例 ,女 2 6例 ,平均年龄 (5 8 4± 12 3 )岁 ;存在相同心血管疾病 (高血压或冠心病 )的窦性心律者 (窦性心律组 ) 40例 ,男 2 0例 ,女 2 0例 ,平均年龄 (5 7 6± 11 7)岁 ;健康体检者 3 5例为对照组 ,其中男 17例 ,女 18例 ,平均年龄 (5 2 4± 18 5 )岁。测定以上 3组患者血浆纤维蛋白原、D 二聚体、组织纤溶酶原激活剂、组织纤溶酶原抑制剂水平及凝血酶原时间、凝血酶时间和部分凝血活酶时间。 结果 :非瓣膜性心房颤动患者血浆纤维蛋白原、D 二聚体和组织纤溶酶原抑制剂水平显著升高 ,血浆组织纤溶酶原激活剂水平显著降低。凝血酶原时间、凝血酶时间和部分凝血活酶时间则无显著变化。 结论 :非瓣膜性心房颤动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 years) ,rhythm patients with the same hypertension or coronary heart disease 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 years) .Plasma levels of fibrinogen (FIB) ,fibrin D dimer (D D) ,tissue plasminogen activator (tPA) ,its inhibitor (PAI) B Q ,prothrombin time (PT) ,thrombin time (TT) and activated part thromboplastin time (APTT) were measured 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 patients.