摘要
目的 探讨老年慢性心房颤动患者血栓形成前状态的相关因素. 方法 选取2009年5月至2011年5月我院收治的老年慢性心房颤动患者142例,根据食道心脏彩色超声检查（TEE）分为血栓形成前状态组（PTS组）90例和无血栓形成前状态组（非PTS组）52例.检测两组患者的左房内径（LAD）、射血分数（LVEF）、高敏C-反应蛋白（hs-CRP）、D-二聚体（D-D）、血浆β-血小板球蛋白（β-TG）、B型利钠肽（BNP）,P选择素（PS）,内皮损伤标志物血管性血友病因子（vWF）和花生四烯酸（AA）诱导的血小板聚集率.多因素Logistic回归分析慢性心房颤动患者血栓形成前状态的相关因素. 结果 PTS组患者心房颤动时间、二尖瓣反流例数、hs-CRP、D-D、β-TG、BNP、PS,vWF和AA诱导的血小板聚集率分别为（6.9±1.8）年、39例（43.3％）、（7.8±1.0）mg/L、（706.6±38.1）μg/L、（147.2±21.3）μg/L、（1075.4±31.2）ng/L、（88.5±13.9）μg/L、（36.1±11.2）×10-3U/L和（27.4±12.6）％,均明显高于非PTS组患者（4.7±1.3）年、11例（21.2％）、（2.7±0.4） mg/L、（270.4±28.5）μg/L、（117.7±17.1）μg/L、（222.6±26.0）ng/L、（37.4±11.2）μg/L、（26.4±9.9）×10-3 U/L和（19.7±5.7）％,组间差异均具有统计学意义（t=4.52、11.18、15.31、31.20、4.89、166.46、22.59、14.06、5.45,均P＜0.01）.多因素Logistic回归分析结果显示,心房颤动时间、二尖瓣反流、hs-CRP、PS、vWF和AA诱导血小板聚集率为慢性心房颤动患者血栓形成前状态的独立危险因素（OR=3.57、2.19、2.91、3.28、2.37、1.98,均P＜0.05）. 结论 心房颤动时间、二尖瓣反流、血浆中hs-CRP、PS含量、vWF和AA诱导的血小板聚集率可作为老年心房颤动患者并发血栓前状态的预测因素.
Objective To explore the correlation between prethrombotic state （PTS）and chronic atrial fibrillation in elderly patients,and to analyze the risk factors.Methods A total of 142 elderly patients with chronic atrial fibrillation from May 2009 to May 2011 were selected.Patients were divided into the PTS group （n =90） and no-PTS group （n =52） by transesophageal echocardiography （TEE）.The left atrial diameter （LAD）,left ventricular ejection fraction （LVEF）,levels of high-sensitivity c reactive protein （hs-CRP）,D-Dimer （D-D）,β-platelet globulin （β-TG）,B type brain natriuretic peptide （BNP）,P-select element （PS）,endothelial damage/dysfunction mark （vWF） and platelet aggregation rate-AA （PAR-AA）were determined.The related factors of prethrombotic state in elderly patients with chronic atrial fibrillation were analyzed by the multiple regression analysis.Results There were significant differences in the time of atrial fibrillation,frequency of patients with mitral regurgitation,levels of hs-CRP,D-D,β-TG,BNP,PS,vWF and PAR-AA between the PTS group and the non-PTS group [（6.9±1.8）years vs.（4.7±1.3）years,39 cases （43.3%）vs.11 cases （21.2%）,（7.8±1.0）mg/L vs.（2.7±0.4）mg/L,（706.6±38.1）μg/L vs.（270.4±28.5）μg/L,（147.2± 21.3） μg/L vs.（117.7±17.1）μg/L,（1075.4±31.2）ng/L vs.（222.6±26.0）ng/L,（88.5±13.9）μg/Lvs.（37.4±11.2）μg/L,（36.1±11.2） ×10-3U/L vs.（26.4±9.9）×10-3U/L,（27.4±12.6）% vs.（19.7±5.7）%,t=4.52,11.18,15.31,31.20,4.89,166.46,22.59,14.06,5.45,respectively,all P〈0.01].Multivariate logistic regression analysis showed that the time of chronic atrial fibrillation,mitral regurgitation,levels of hs CRP,PS,vWF and PAR-AA were independent risk factors for PTS in elderly patients with atrial fibrillation （OR=3.57,2.19,2.91,3.28,2.37,1.98,respectively,all P〈0.05）.Conclusions The time of atrial fibrillation,mitral regurgitation,levels of hsCRP,PS,vWf and PAR-AA are independent risk factors for PTS in elderly patients with chronic atrial
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第5期483-485,共3页
Chinese Journal of Geriatrics
关键词
冠心病
细胞色素P450酶系统
多态性
单核苷酸
Coronary disease
Cytochrome P-450 enzyme system
Polymorphisms, singlenucleotide
