非瓣膜病心房颤动患者血小板活化状态的研究

Changes of platelet activity in middle-old aged patients with nonvalvular atrial fibrillation

目的了解非瓣膜病心房颤动(房颤)患者血小板的活化状态。方法观察92例非瓣膜病持续性房颤患者(房颤组)与60例窦性心律者(对照组)血小板功能状态的分子标记物水平,用酶联免疫吸附双抗体夹心法测定血浆血小板α颗粒膜糖蛋白-140(GMP-140)水平,用放射免疫分析法测定血栓素B2(TXB2)和6-酮-前列腺素F1α(6-k-PGF1α)水平。结果房颤组GMP-140和TXB2水平显著高于对照组,6-k-PGF1α水平显著低于对照组,TXB2/6-k-PGF1α比值也显著高于对照组。调整其他影响因素后,房颤组GMP-140和TXB2水平仍显著高于对照组,6-k-PGF1α水平仍显著低于对照组。GMP-140水平在合并糖尿病和合并高甘油三酯血症的房颤患者进一步升高。结论非瓣膜病房颤患者处于血小板激活状态。

Objective To study the changes of platelet activity in patients with nonvalvular atrial fibrillation. Methods Levels of platelet activity markers were measured in 92 patients aged 45 - 80 with persistent nonvalvular atrial fibrillation （AF group） and 60 patients with sinus rhythm （control group）. Enzyme linked immunosorbent assay was used to measure plasma platelet granular membrane protein-140 （GMP-140） and radioimmunoassay was used to measure plasma thromboxane B2 （ TXB2 ） and 6-keto-prostaglandin F1α （ 6-k-PGF1α ）. Results The patients in AF group had significantly higher plasma GMP-140 and TXB2 and lower plasma 6-k-PGF1α compared with the patients in control group. The patients in AF group also had significantly higher ratio of TXB2/6-k-PGF1α. Multivariate analysis showed that the differences of GMP-140, TXB2 and 6-k-PGF1α between the 2 groups were not affected by the other factors. In AF group, plasma level of GMP-140 was higher in the patients complicated by diabetes and hypertriglyceridemia. Conclusion The present results indicated that the patients with nonvalvular atrial fibrillation are in the state of platelet activation.