摘要
目的分析非瓣膜病性心房颤动（NVAF)患者血栓前体蛋白（TpP)与P选择素（Ps)水平变化。方法选择2014年5月~2015年10月于沈阳医学院附属第二医院心血管内科住院治疗NVAF患者206例（NVAF组），男性132例，女性74例，年龄39~79岁。另人选冠状动脉粥样硬化性心脏病（冠心病）(78例）和扩张型心肌病（扩心病）（2例）无心房纤颤（房颤）患者作为对照组（80例）aNVAF组患者依据CHADS2评分分为CHADS232组（87例）及CHADS2<2组（119例）；另夕卜NVAF组患者中接诊时可明确AF发作时间者共87例，按AF持续时间分为>48h组（59例）及<48h组（28例）；此外NVAF组患者中住院期间可明确区分AF类型者共102例，分为持续性AF组（66例）和阵发性AF组（36例）。收集人选者病例记录的基线资料包括：性别、年龄、左房内径（LAD)、左室射血分数（LVEF)、AF持续时间和类型、CHADS2评分等。应用酶联免疫吸附法测定Ps和TpP水平。结果NVAF组与对照组年龄、性别构成、合并疾病比例、LAD、LVEF比较，差异无统计学意义（P均>0.05)〇NVAF组较对照组TpP、Ps略有升高，但差异无统计学意义（P均>0.05)。与CHADS2<2组比较，CHADS232组年龄增力口，合并高血压与糖尿病比例增加，TpP及Ps水平显著升高，差异有统计学意义（P均<0.05hAF持续时间為48h组及<48h组年龄、性别构成、合并疾病比例、LAD、LVEF比较，差异无统计学意义（尸均>0.05)。為48h组较<48h组TpP及Ps水平偏高，但差异无统计学意义（P均>0.05)。持续性AF组和阵发性AF组年龄、性别构成、合并高血压比例、LAD、LVEF比较，差异无统计学意义（P均>0.05)。持续性AF组较阵发性AF组合并糖尿病比例、TpP水平、Ps水平偏高，但差异无统计学意义（P均>0.05)。结论NVAF患者当CHADS2彡2时TpP及Ps水平增高，监测TpP和Ps水平有益于识别卒中危险。
Objective To analyze the level changes of thrombus precursor protein(TpP)and P-selectin(Ps)inpatients with non-valvu1ar atrial fibrillation(NVAF).Methods NVAF patients(n=206,male132,female74andaged from39to79)were chosen and included into NVAF group from the Department of Cardiovascular Diseases of theSecond Affiliated Hospital of Shenyang Medical College from May2014to Oct.2015.The patients with coronary heartdisease(CHD,n=78)and dilated cardiomyopathy(DCM,n=2)were chosen and included into control group(n=80).NVAF group was divided,according to CHADS2scores,into C H A D S2^2group(n=87)and CHADS2<2group(n=119).There were87cases in NVAF group with definite AF attack time and they were divided into^48h group(n=59)and<48h group(n=28).In addition,there were102cases in NVAF group with definite AF types and they weredivided into sustained AF group(n=66)and paroxysmal AF group(n=36).The baseline materials were collected fromthe patients,including sex,age,left atrial diameter(LAD),left ventricular ejection fraction(LVEF),duration and typesof AF and CHADS2scores.The levels of Ps and TpP were detected by using enzym e-linked immunosorbent assay(ELISA).Results The comparison in compositions of age and sex,ratio of patients with complicating diseases,LADand LVEF had no statistical significance between NVAF group and control group(all P>0.05).The levels of TpP andPs increased a little in NVAF group compared with control group but the difference was not statistically significant(allP>0.05).Compared with CHADS2<2group,age and ratio of patients with complicating hypertension and diabetesincreased,and levels of TpP and Ps increased significantly in CHADS2多2group(all P<0.05).The comparison incompositions of age and sex,ratio of patients with complicating diseases,LAD and LVEF had no statistical significancebetween^48h group and<48h group(all P>0.05).The levels of TpP and Ps increased a little in^48h groupcompared with<48h group but the difference was not statistically significant(all P>0.05).The comparison incompositions of age and sex,ratio of patients with hypertension,LAD and LVEF had no statistical significance between sustained AF group and paroxysmal AF group(all P>0.05).The ratio of patients with complicating diabetes andlevels of TpP and Ps were higher in sustained AF group than those in paroxysmal AF group but the difference was notstatistically significant(all P>0.05).Conclusion The levels of TpP and Ps are higher in NVAF patients with CHADS2^2.Monitoring the levels of TpP and Ps is beneficial to identifying stroke risk.
作者
赵红丽
刘丽敏
张晓丹
周佳萌
王小溪
ZHAO Hong-li;LIU Li-min;ZHANG Xiao-dan;ZHOU Jia-meng;WANG Xiao-xi
出处
《中国循证心血管医学杂志》
2016年第11期1326-1328,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
沈阳市科技创新专项资金(F14-158-9-27)
沈阳医学院科技基金项目(20131013)
关键词
血栓前体蛋白
P选择素
心房颤动
Thrombus precursor protein
P-selectin
Atrial fibrillation
