摘要
目的:研究非瓣膜性心房颤动(AF)患者高凝状态指标的检测及抗栓治疗后的变化情况。方法:取临床基本情况匹配的窦性心律患者35例为对照组,非瓣膜性AF患者(慢性AF)45例,随机分入华法林组(26例)和阿司匹林组(19例)。分别测定PT／INR／FIB／APTT,vWF,D-Dimer,t-PA:Ag,PAI-1:Ag等项目。结果:PT／INR／APTT／FIB等常规血凝学指标在AF组和对照组差异无显著性(P>0．05)。AF组D-Dimer显著高于对照组(P=0．042),且有栓塞事件者高于无栓塞事件者(P=0．010)。AF组t-PA:Ag,PAI-1:Ag明显高于对照组(P<0．001),但与栓塞事件无明显相关。华法林抗凝治疗后D—Dimer,显著下降(P=0．004)。阿司匹林组服药后指标改变不显著。结论:常规血凝学项目PT／INR／APTT／FIB不能作为评价AF高凝状态的指标。建议D-Dimer,t-PA:Ag,PAI-1:Ag作为AF高凝状态的指标,且D-Dimer与预后相关;D-Dimer也是抗凝治疗效果监测的良好指标。阿司匹林不能改善血凝指标。
Objective： To determine the prothrombotic indices of nonvalvular atrial fibrillation （NVAF）, and their changes after antithrombotic therapy.Methods： The study random divided 45 chronic atrial fibrillation patients to Warfarin group and Asprin group. FT/INR/AFIT/FIB and vWF, D - Dimer, t - PA： Ag, PAI - 1： Ag were tested.Then compared chnical status patients recruited in the Control group. Results： FF/INR/AFIT/FIB have no significant differents between basline and control group（P 〉 0. 05）. NVAF patients have higer D - Dimer than control group （P = 0. 042）, it also associated with thrombosis （P = 0.010 ）. After OAT, d - dimer drop off greatly . The t- PA：AgandPAI- 1 ：AgofNVAF patients were two times those of control, but it was not associated with thrombosis. After OAT, PAI - 1： Ag raised a lot though t - PA： Ag didn＇ t change. The changes of Asprin group were not significant. Conclusion： Routine coagulation tests couldn＇ t be selected as prothrombotic indices of NVAF patients. D - dimer can be a good prothrombotic indice and prognosis thrombosis of NVAF patients; it also a good indite moniter OAT therapy.
出处
《中国医药导刊》
2006年第4期266-269,共4页
Chinese Journal of Medicinal Guide
关键词
非瓣膜性AF
高凝状态
D-二聚体
纤溶酶原激活物
抑制物
Nonvavular atrial fibrillation
Prothrombotic state
D - dimer
plasminogen activator
inhibitor
