抗凝治疗对非瓣膜性心房颤动患者纤溶指标的动态影响

韩冰; 黄全跃; 刘樊

doi:10.13201/j.issn.1001-1439.2013.03.016

抗凝治疗对非瓣膜性心房颤动患者纤溶指标的动态影响

- 中南大学湘雅二医院心内科(长沙, 410011)

详细信息

通讯作者: 黄全跃,E-mail:hqy2248@medmail.com.cn

中图分类号: R541.7

收稿日期: 2012-10-10

Effects of anticoagulant therapy on alteration of fibrinolysis parameters in patients with nonvalvular atrial fibrillation

- Department of Cardiology, the Second Xiangya Hospital of Central South University, Changsha, 410011, China

More Information

Corresponding author: HUANG Quanyue, E-mail: hqy2248@medmail.com.cn

Received Date: 10 October 2012

摘要

摘要: 目的:探讨纤溶因素在非瓣膜性心房颤动(房颤)患者高凝状态形成中的作用及抗凝治疗早期纤溶指标浓度的变化趋势。方法:应用酶联免疫吸附(ELISA)法分别测定窦性心律组(窦律组,27例)及房颤组(25例)患者抗凝治疗各时间点(1d、7d、1个月、2个月)组织型纤溶酶原激活物抑制剂-1(PAI-1)、D-二聚体(D-dimer)浓度和INR值。分析两组患者PAI-1和D-dimer浓度的差异、该指标随抗凝治疗时间的变化趋势及PAI-1、D-dimer和INR三者之间的相关性。结果:①房颤组PAI-1和D-dimer水平均明显高于窦律组;②PAI-1和D-dimer浓度在抗凝治疗各时间点均差异有统计学意义(均P<0.05),PAI-1浓度随抗凝治疗各时间点下降百分比分别为7%、18%及31%,D-dimer浓度分别下降19%、34%及43%;③房颤组PAI-1浓度在抗凝治疗1个月、2个月时与窦律组比较均差异有统计学意义(均P<0.05),D-dimer浓度治疗7d、1个月时均差异有统计学意义(均P<0.05);④INR≤2.0较INR>2.0组PAI-1和D-dimer均值较高(均P<0.05)。相关分析发现PAI-1、D-dimer和INR之间均呈显著负相关(r值分别为-0.263、-0.443,P值分别为0.010、0.000),PAI-1和D-dimer之间呈显著正相关(r=0.468,P=0.000)。结论:低纤溶状态可能是非瓣膜性房颤患者高凝状态形成的重要原因;抗凝治疗可有效快速改善房颤患者的低纤溶状态。
- 心房颤动 /
- 非瓣膜性 /
- 组织型纤溶酶原激活物抑制剂-1 /
- D-二聚体
Abstract: Objective:To explore the role of fibrinolysis system in the formation of hypercoagulable state with nonvalvular atrial fibrillation(NVAF) patients and investigate the variation tendency of PAI-1 and D-dimer levels along with the anticoagulant therapy.Method:Patients were divided into NVAF group(n=25) and control group(sinus rhythm with age-matched hypertensive patients,n=27).ELISA method was used to detect the plasma levels of PAI-1and D-dimer.The difference of PAI-1,D-dimer levels in two groups,the variation tendency of the two indexes along with anticoagulant therapy,and the correlation among PAI-1,D-dimer and INR were analyzed.Result:①The levels of PAI-1and D-dimer in NVAF group were higher than those in control group(both P< 0.05).②The plasma levels of PAI-1and D-dimer significant changed at each time points(the 1st day,7th day,1st month,2nd month)(all P<0.05).The decreased percentage of PAI-1concentration were 7%,18% and 31%,respectively;while D-dimer were 19%,34% and 43%.③The variations of PAI-1level at 1st month and 2nd month were different between control group and NVAF group(both P<0.05),the variations of D-dimer level at 7th day and 1st month were different between control group and NV AF group(both P<0.05).④PAI-1and D-dimer levels were higher in INR≤2.0group than those in INR>2.0group.PAI-1,D-dimer and INR levels were negatively correlated(r were-0.263,-0.443;P were 0.010,0.000,respectively),while PAI-1and Ddimer were positively correlated(r=0.468,P=0.000).Conclusion:Low fibrinolysis state is an important factor in the formation of hypercoagulable state in NVAF.Anticoagulant therapy can improve the fibrinolysis state in NVAF patients quickly and effectively.
- atrial fibrillation /
- nonvauvular /
- plasminogen activator inhibitor-1 /
- D-dimer

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