孤立性心房颤动患者血浆血小板α颗粒膜蛋白-140和血栓素B_2及6-酮-前列腺素F_(1α)浓度变化的研究

目的研究孤立性心房颤动(房颤)患者血小板功能改变,探讨房颤引起血栓前状态的原因。方法用放射免疫分析法对21例孤立性阵发性房颤(A组)、28例孤立性持续性房颤(B组)患者分别于房颤发作及终止后1周测定外周静脉血浆血小板а颗粒膜蛋白-140(GMP-140)、血栓素B2(TXB2)、6-酮-前列腺素F1α(6-K-PGF1α)浓度,并与27例风湿性心脏病二尖瓣狭窄伴持续性房颤(C组)、32例阵发性室上性心动过速患者(D组)及与20例健康体检者(对照组)相比较。结果A、B组患者房颤发作时及C组患者GMP-140、TXB2和TXB2/6-K-PGF1α比A组患者房颤终止后1周和D组及对照组明显上升。A组患者血浆GMP-140、TXB2浓度及TXB2/6-K-PGF1α与房颤发作时间呈正相关,而与患者年龄、性别及左心房内径等临床参数无关。结论无论是器质性心脏病房颤还是孤立性房颤,无论是阵发性房颤还是持续性房颤都存在血小板的激活和血管内皮细胞功能损伤。

The changes of plasma GMP-140, TXB2 and 6-K-PGF1α in the patients with lone atrial fibrillation

Objective To investigate the function change of platelet in the patients with lone atrial fibrillation(AF) and to explore the mechanism of prethrombotic state caused by AF.Methods Radioimmunoassay was used to measure plasma granule membrane protein-140(GMP-140),TXB_2 and 6-K-PGF_(1α) levels in 21 patients with lone paroxysmal AF(Group A) and 28 patients with lone sustained AF(Group B) during AF and 7 days after returning to sinus rhythm.Levels of these markers were compared with those in 27 patients with rheumatic heart disease and chronic AF(Group C),32 patients with paroxysmal supraventricular tachycardia(Group D)and 20 healthy subjects.Results Patients of group A during AF,group B and group C had high levels of GMP-140,TXB_2 and TXB_2/6-K-PGF_(1α) as compared with patients of group D and the healthy subjects.The plasma levels of these markers in group D were similar to the levels in healthy subjects and patients of group A after 7 days of recovery.There were positive correlations between the duration of AF and the levels of these markers,but it was not relevant to left atrial size on echocardiography,sex,ages,etc.Conclusion These results indicate that AF itself enhances platelet activities,which is influenced by the duration of AF.