心脏瓣膜手术前后血浆血小板因子4和β血小板球蛋白改变的临床研究

PRE-AND POST-OPERATIVE PLASMA FACTOR 4 AND β-THROMBOGLOBULIN CONCENTRATIONS IN PATIENTS WITH HEART VALVULAR DISEASE

对３０例心脏瓣膜患者手术前后血浆血小板因子４（ＰＦ４）和β血小板球蛋白（βＴＧ）浓度测定显示，术前心房颤动病例的ＰＦ４和βＴＧ浓度高于窦性心率病例，瓣膜替换病例术后ＰＦ４和βＴＧ高于单纯二尖瓣闭式扩张病例。本文提出，术前心房颤动病例及瓣膜替换术后病例的体内血小板处于活化状态，具有血栓形成倾向，并对ＰＦ４和βＴＧ升高的成因及其临床意义进行讨论。

Plasma platelet factor 4(PF4) ,β-thromboglobulin (βTG)and platelet were measured in 30 patients undergone heart valvular operations. PF4 and βTG levels,by ELISA,were higher in patients with atrial fibrillation than those with sinus rhythm pre-operatively (PF4 45. 20 ±22. 60 ng/ml vs 15. 41 ±11. 70 ng/ml, p< 0.01; βTG 80.49±35. 09 μg/ml vs 21. 40±16. 46 μg/ ml,p<0. 001). Left atrial embolism was found in 2 out of 3 cases with higher βTG concentration (>100 μg/ ml). In patients after implantation of prosthetic heart valves, PF4 and βTG concentrations were higher. These findings indicate that platelets are activated in patients with atrial fibrillation and artificial valve replacement , which are known to have greater risk of embolism. The determination of plasma PF4 and βTG concentrations is useful for the detection of platelet activation and timely initiation of measures for inhibiting platelet aggregation and anticoagulation to prevent embolism.(Department of Pathopbysiology, Shanghai Second MedicalUniversity,Shanghai)