Effect of rivaroxaban on procoagulant activity of platelets and microparticles in patients with non-valvular atrial fibrillation
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摘要: 目的:研究利伐沙班对非瓣膜心房颤动(NVAF)患者体内血小板及微粒(MPs)促凝活性的影响。方法:选取2016-10-2019-05期间在我院治疗的NVAF患者(口服利伐沙班进行抗凝治疗)47例作为NVAF组;另选取同期在我院门诊进行体检的健康志愿者45例作为对照组。比较各组的血常规指标、磷脂酰丝氨酸(PS)阳性的血小板、MPs水平,并采用凝血实验和纤维蛋白生成实验分析血小板及MPs的促凝活性的变化。结果:NVAF组治疗前的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于对照组,D-D聚体水平高于对照组(P<0.05),NVAF组治疗后的PT、APTT延长,D-D聚体水平降低(P<0.05),NVAF组治疗后PT、APTT仍短于对照组,D-D聚体水平仍高于对照组(P<0.05)。NVAF组治疗前PS+血小板、总MPs及血小板释放的微粒(PMPs)水平高于对照组(P<0.05),NVAF组治疗后PS+血小板水平、总MPs水平及PMPs水平降低,但仍高于对照组(P<0.05)。NVAF组患者在治疗前血小板及MPs促凝血时间短于对照组(P<0.05),NVAF组治疗后的血小板及MPs促凝血时间明显延长,但仍短于对照组(P<0.05)。NVAF组患者在治疗前血小板及MPs促纤维蛋白生成能力高于对照组(P<0.05);NVAF组治疗后血小板及MPs促纤维蛋白生成能力明显降低,但仍高于对照组(P<0.05)。结论:利伐沙班降低了NVAF患者体内血小板及MPs促凝活性。Abstract: Objective:To study the effect of rivaroxaban on procoagulant activity of platelets and microparticles(MPs) in patients with non-valvular atrial fibrillation(NVAF).Method:The 47 patients with NVAF(taking rivaroxaban orally for anticoagulation therapy) who were treated from October 2016 to May 2019 were selected as NVAF group.Another 45 healthy volunteers who underwen physical examination during the same period were selected as the control group.The blood routine indexes,phosphatidylserine(PS) positive platelets,the level of MPs in each group were compared.Coagulation test and fibrinogenesis test were used to analyze the changes of procoagulant activity of platelets and MPs.Result:The prothrombin time(PT) and activated partial thromboplastin time(APTT) in NVAF group before treatment were shorter than those of control group,and the level of D-D polymer was higher than that of control group(P<0.05).PT and APTT were prolonged and the level of D-D polymer was decreased in NVAF group after treatment(P<0.05).PT and APTT in NVAF group after treatment were still shorter than those in control group,and the level of D-D polymer was still higher than that in control group(P<0.05).The levels of PS+ platelets,total MPs and platelet-released particles(PMPs) in NVAF group before treatment were higher than those in control group(P<0.05).The levels of PS+ platelet,total MPs and PMPs in NVAF group after treatment were decreased,but they were still higher than those in control group(P<0.05).The time of platelet and MPs procoagulation in NVAF group before treatment was shorter than that in control group(P<0.05).The time of platelet and MPs procoagulation in NVAF group after treatment was significantly prolonged,but it was still shorter than that in control group(P<0.05).The fibrinogenesis of platelets and MPs in NVAF group before treatment was higher than that in control group(P<0.05).The fibrinogenesis of platelets and MPs in NVAF group after treatment was significantly decreased,but it was still higher than that in control group(P<0.05).Conclusion:Rivaroxaban can reduce the procoagulant activity of platelets and MPs in patients with NVAF.
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Key words:
- non-valvular atrial fibrillation /
- rivaroxaban /
- platelet /
- microparticles /
- phosphatidylserine /
- procoagulant activity
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