血浆D-二聚体水平变化在心脏房颤血栓前状态诊断的意义

The significance of changes of plasma D-dimer level in diangnosis of atrial fibrillation

目的探讨房颤持续时间与复律前后血浆D-二聚体水平的变化关系。方法将42例心脏房颤病人分成A、B两组,A组房颤持续时间为72h或以上(142.7±103.8h),B组房颤持续时间少于72h(25±16h)。以酶免疫法测定对复律前和复律后36h的血浆D-二聚体水平,并与19例对照组比较。结果与对照组相比,A、B两组病例复律前血浆D-二聚体水平均明显增高(P<0.05),并与房颤持续时间有显著相关。结论房颤持续时间越长,复律后血栓前状态越明显;房颤持续时间和D-二聚体水平可作为房颤复律血栓前状态的新的预测物。

Objective To incestigate whether the duration of atrid fibrillation influences the haemostasis measured by plasma D - dimer levels. Methods 42 patients wirh atrial fibrillation undergoing cardioversion wert divided into two groupo ： In Gronp A（ n =24,14male,56 ± 11years） the duration of atrial fibrillation was 72 hours or more （142.7 ± 103.8hours）,in Group B（n = 18, 10male,61 ± 13years）the duration of atrid fibrillation was less than 72 hours （25 ± 16hours）. plasma D - dimer levels 36hours after cardioversion was calculated as △ D - dimer. Results Compared to the Control, the baseline D - dimer levels were significantly higher in both groups. The absolute values of △ - D - dimer levels were significantlg higher in Group A than in group B （ P 〈 0. 005）. Conclusion Furthermore, plasma D- dimer levels 36hours after condioversion（R = 0.52, P = 0.0016）and △ - D - dimer levels （R = 0.73, P 〈 0.0001 ）showed sisnificant correlations with the duration of atrial fibrillation episode conld lead to a more prominent prothrombotic state . the duration of the atrial fibrillation episode and △- D - dimer levels conld be used as the useful clinical markers of the prothrombotic state after successful cardioversion.