心房颤动患者抗凝治疗前后微栓子及血浆D-二聚体水平观察

目的：观察心房颤动患者华法林治疗前后微栓子检出率及血浆 D-二聚体水平。方法选择 CHADS2评分≥1分的持续性房颤患者40例，每例患者华法林抗凝治疗前后分别行微栓子监测和 D-二聚体水平检查，比较治疗前后结果差异。结果抗凝治疗前微栓子阳性12例、阴性28例，治疗后微栓子阳性5例、阴性35例，抗凝治疗后微栓子检出率显著降低（30．0％ vs．12．5％，χ2＝3．66，P ＜0．05）；D-二聚体水平抗凝治疗前为（273±81）μg／L，治疗后为（170±67）μg／L。治疗后血浆 D-二聚体水平显著降低（t ＝10．09，P ＜0．05）。结论微栓子与 D-二聚体水平均可以作为房颤患者栓塞风险的评估指标。

Observation on microembolic signal and D-dimer level of atrial fibrillation patients before and after anticoagulant therapy

Objective To observe the microembolic signal(MES)and D-dimer level of atrial fi-brillation patients before and after warfarin anticoagulant therapy.Methods A total of 40 persistent atrial fibrillation patients with CHADS2 score≥1 were selected.Each of research object underwent MES monitoring and D-dimer level detection before and after warfarin anticoagulant therapy.We compared the results before and after the treatment.Results Before anticoagulant therapy,there were 1 2 cases with positive MES and 28 with negative MES;after the treatment,5 cases were posi-tive in MES and 35 were negative.The positive rate of MES significantly decreased after anticoagulant therapy(30.0% vs.12.5%,χ2 =3.66,P <0.05).The level of D-dimer was (273 ±81 )μg/L before anticoagulant therapy and (170 ±67)μg/L after the therapy.The level of plasmatic D-dimer significantly reduced after the treatment(t =10.09,P <0.05 ).Conclusion Both of MES and D-dimer level can be regarded as risk evaluation indicators of embolism in atrial fibrillation patients.