窦性心律心力衰竭患者凝血状态的变化

目的 :研究窦性心律慢性心力衰竭 (心衰 )患者体内凝血状态的变化 ,并探讨其临床意义。方法 :采用ELISA法测定 4 0例慢性心衰患者及 15例健康者 (正常对照组 )血浆P 选择素、血管性血友病因子 (vWF)、D 二聚体水平 ,并将 4 0例慢性心衰患者按是否服用阿司匹林随机分为阿司匹林组 (A组 ) 2 0例 ,非阿司匹林组 (B组 )2 0例 ,A组为标准心衰治疗加阿司匹林 75mg/d ,B组为标准心衰治疗 ,两组患者治疗 2周后 ,分别测定血浆P 选择素、vWF、D 二聚体水平。结果 :慢性心衰患者血浆P 选择素、vWF、D 二聚体水平明显高于正常对照者 ,A组与B组治疗后血浆P 选择素、vWF、D 二聚体水平与治疗前相比有所下降 ,差异有显著性意义 ,但两组改善P 选择素、vWF、D 二聚体的效果相似。结论 :慢性心衰患者体内存在高凝状态 ,这与心衰血栓形成或血栓栓塞有关 ,阿司匹林对心衰患者的凝血状态改变无影响

Changes of the coagulationary state in patients with chronic heart failure in sinus rhythm

Objective:To study changes of the coagulationary state in patients with chronic heart failure(CHF) in sinus rhythm and its clinical significance.Methods:Plasma P-selectin, vWF and D-dimer were detected in 15 normal control and 40 patients with CHF by ELISA. Fouty patients with CHF were randomly divided into 2 groups based on asipirin therapy, group A (n=20) with asipirin and standard therapy, group B(n=20) only with standard therapy for 14 days. Plasma P-selectin, vWF and D-dimer were detected at baseline and 14 days after treatment. Results:The level of plasma P-selectin, vWF and D-dimer in group A and in group B were significantly reduced after treatment, but there were no significant differences between group A and group B.Conclusion:A hypercoagulable state is existed in the patients with CHF which may be associated with an increased risk of thromboembolism. Asipirin has no effect on changes of coagulationary state in patients with CHF.