心房颤动患者血浆D-二聚体与纤维蛋白元变化及其临床意义

THE CHANGE OF PLASMA D-DIMER AND FIBRINOGEN LEVEL AND ITS CLINICAL SIGNIFICANCE IN PATIENTS WITH ATRIAL FIBRILLATION

目的 :观察慢性心房颤动 (房颤 )患者血浆D -二聚体和纤维蛋白元水平的变化 ,并探讨其意义。方法 :测量 48例房颤患者 (其中风心病 2 8例 ,冠心病 2 0例 )和 30例正常人血浆D -二聚体 (D -dimer)和纤维蛋白元(Fg) ;并测定血浆凝血酶原时间 (PT)和部分凝血活酶时间 (APTT)。结果 :房颤患者与正常人相比 ,血浆D -dimer浓度极显著升高 (0 .47± 0 .45对 0 .14± 0 .0 6mg L ;P <0 .0 1) ,纤维蛋白元水平也显著升高 (3.34± 0 .94对 2 .5 4±0 .5 5g L ,P <0 .0 1)。而PT、APTT差异无显著性 (P >0 .0 5 )。风心病患者与冠心病患者之间D -dimer,Fg及PT、APTT差异均无显著性 (P >0 .0 5 )。结论 :房颤患者血浆D -dimer和Fg水平升高 。

Objective: To observe the change of plasma D-dimer and fibrinogen levels in patients with chronic atrial fibrillation,and verify its clinical significance. Method: The plasma levels of D-dimer,fibrinogen(Fg), prothrombin time (PT) and activated partial thromboplastin time(APTT) were measured from 48 patients with atrial fibrillation. 28 patients had rheumatic heart dialsease(RHD) and another 20 patients had coronary heart disease (CHD).Levels were compared with those found in the plasma of 30 health subjects. Result: Patients with atrial fibrillation had higher levels of D-dimer and fibrinogen than controls(P<0.01).No significant differences were found either in PT and APTT between atrial fibrillation and controls (P>0.05).No significant differences were found in D-dimer,Fg, PT and APTT between rheumatic and nonrheumatic fibrillation(P>0.05).Conclusion: The plasma levels of D-dimer and fribrinogen in patients with atrial fibrillation are high,which may contribute to increased risk of thrombosis.