C反应蛋白与心房颤动合并血栓的相关分析

目的 探讨C反应蛋白(CRP)与非瓣膜性心房颤动(房颤)患者左心房内血栓形成的关系。方法 按照经食道心脏超声(TEE)检查结果将非瓣膜性房颤患者154例分为：血栓组46例、非血栓组108例。检测血浆中CRP、D-二聚体的浓度及TEE检测左心房直径(LAd)、左室射血分数(LVEF)、缩短分数(FS)。将可能的相关因素进行logistic多因素回归分析。结果 血栓组患者在CRP(5.77±6.37) mg/L比(1.73±2.39) mg/L,P=0.003]、LAd(59.86±10.70)mm比(47.97±13.19)mm,P＜0.001]、LVEF(58.75±8.28)％比(64.10±6.75)％,P＜0.001]与非血栓组差异有统计学意义。logistic回归发现CRP≥1.33 mg/L(OR 2.856,95％CI1.235 ～6.600,P=0.014),LAd≥54.5 mm(OR 4.236,95％ CI 1.877 ～9.562,P=0.001)是非瓣膜性房颤患者血栓形成的独立危险因素。结论 CRP升高、左心房扩大是非瓣膜性房颤患者血栓形成的独立危险因素,炎症反应可能参与心房血栓形成。

C-reactive protein and non-valvula atrial fibrillation combining with thrombosis

Objective To investigate the alteration of plasma C-reactive protein (CRP) count in patients with non-valvula atrial fibrillation combining thrombosis.Methods A total of 154 patients with non-valvula atrial fibrillation were divided into thrombus group (n = 46) and non-thrombus group (n = 108)in accordance with transesophageal echocardiography (TEE) results.The concentration of CRP by scattering turbidimetry, D-dimer by immunoturbidmetry, left atrium diameter (LAd), fraction shortening (FS) and left ventricular ejection fraction (LVEF) by TEE or echocardiography were detected.Logistic multi-factors regression analysis was performed.Results There were significant differences in CRP (5.77 ± 6.37)mg/L vs (1.73 ±2.39)mg/L,P =0.003], LAd (59.86 ± 10.70) mm vs (47.97 ± 13.19)mm,P ＜0.001]and LVEF(58.75 ±8.28)％vs (64.10 ±6.75)％, P ＜0.001]between thrombus group and nonthrombus group.The results of logistic regression analysis found CRP ≥ 1.33 mg/L(OR 2.856, 95％ CI 1.235-6.600,P =0.014) and LAd≥54.5 mm(OR 4.236, 95％ CI 1.877-9.562,P =0.001) were independent risk factors of patients with non-valvula atrial fibrillation combining with thrombosis.Conclusions CRP and LAd are independent risk factors for patients with non-valvula atrial fibrillation combining with thrombosis.Inflammation may involve with the formation of thrombosis.