心房纤颤并发血栓栓塞危险因素分析(1)
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2010年3月25日
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[摘要] 目的:研究分析心房纤颤并发血栓栓塞危险因素。方法:选用中山医科大学附一院就诊的患者90例,随机分为A、B组,所有患者入院时经胸超声采用HP 5500型彩超仪,探头频率为3.5 MHz。准确测量LA内径,并仔细探察左房,尤其是左心耳有无附壁血栓。患者于清晨、空腹、仰卧状态下,用抽取肘静脉血,经过一定的处理过程,采用酶联免疫吸附双抗体夹心法测定血管性假血友病因子(vWF),血浆凝血酶-抗凝血酶复合物(TAT),D-二聚体(D-D)及P-选择素(GMP-140)。结果:A组的LA内径明显高于B组,差异有统计学意义(P<0.05)。A组患者的血浆vWF、TAT、D-D也明显高于B组,差异有统计学意义,而两组的P-选择素差别不大。房颤患者血栓栓塞的独立危险因素为,D-D 浓度增高、LA 内径增大、TAT浓度增大,且D-D 浓度增高的相对危险度(OR值)较大。结论:房颤患者血栓栓塞的独立危险因素是vWF、D-D 浓度增高、LA 内径增大,且D-D 浓度增高的危险因素高于其他因素,结合多个危险因素,可提高诊断房颤血栓栓塞的特异性,更可靠地分析血栓栓塞危险性。
[关键词] 房颤;血栓栓塞;危险因素
[中图分类号] R541.7+5 [文献标识码]A [文章编号]1674-4721(2010)03(c)-029-02
Risk factors of atrial fibrillation complicated with thromboembolism
LIANG Zhonghua,SUN Yuncai,ZHANG Weihua
(Baoan District Shiyan People's Hospital of Shenzhen,Shenzhen 518108, China)
[Abstract] Objective: To study the risk factors of atrial fibrillation complicated with thromboembolism. Methods: An Affiliated treatment of 90 patients were randomly divided into group A and group B,all patients on admission transthoracic color Doppler ultrasound used HP 5500-type instrument,the probe frequency of 3.5 MHz.An accurate measurement of LA diameter,and carefully detect left atrium,in particular,whether the left atrial appendage thrombi.Patients in the early morning,fasting,supine state,with the elbow venous blood taken after a certain process,used double-antibody sandwich enzyme-linked immunosorbent assay determination of von Willebrand factor(vWF),thrombin-antithrombin complex(TAT),D-dimer(DD),and P-selectin(GMP-140). Results: Analysis of LA diameter in group A was significantly higher than group B,there was a significant difference(P<0.05). Patients of group A with plasma vWF,TAT,DD were also significantly higher than group B,there were significant differences in the two groups, pselectin difference was not significant.Thromboembolism in patients with atrial fibrillation were independent risk factors.DD enrichment,LA diameter increased,TAT concentration was increased,and the DD enrichment relative risk(OR value) larger. Conclusion: Thromboembolism in patients with atrial fibrillation an independent risk factor is the concentration of vWF and DD increased,LA diameter increased,and increased the concentration of the risk factors of DD is higher than other factors,combined with multiple risk factors,can increase the specificity of diagnosis of atrial fibrillation thromboembolism and more reliable analysis of thromboembolic risk ......
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