非瓣膜性房颤的高凝状态与左心房大小的关系

目的观察心房纤颤患者血桨中纤维蛋白原、D一二聚体等及左房、左室内径的改变;AF不同持续时间对其影响;及其与左心房大小的相关性.方法选择住院的窦性心律患者24例,房颤患者60例其中阵发性房颤17例,持续性房颤21例,永久性房颤22例.所有患者皆行常规检查及有关化验,以Clouse法检测纤维蛋白原;采用乳胶凝集法测定口一二聚体.并做Lcg olter、超声心动图.结果房颤组与窦性心律组比较,收缩压、舒张压,血小板计数,红细胞压积,EF值以及左心室的舒、缩内径之间无显著差异,但纤维蛋白原、D一二聚体、左心房内径之间有显著差异.将阵发性、持续性与永久性AF分另.与窦性心律组比较,纤维蛋白原、D一二聚体有显著差异,但收缩压、舒张压,血小板计数、红细胞压积、eF值以及左心室的舒、缩内径无显著差异.持续性及永久性 AF者左心房内径有显著性差异.心房纤颤患者的血桨纤维蛋白原含量与左心房大小具有明显的相关性,r = 0.67,p＜0.01.结论AF伴有明显的高凝状态.随着AF持续时间增加,这种改变越来越明显,同时伴内皮损伤的LA扩大与高凝状态明显相关.

Relationship between the levels of plasma coagmatins factors and size of left atfium

Objective: To observe the levels of plasma fibrinogen and D-dimer, and the changes of left atrial and left ventricular size in the patients with atrial fibrillation and in clinical subgroups of atrial fibrillation cases.Methods: The control group include 24 cases in sinus rhythm from inpatient. 60 patients with atrial fibrillation: 17 with paroxysmal AF; 21 with persistent AF and 22 with permanent AF. The levels of plasma fibrinogen, D-dimer, hematocrit, PLA and parameters of left atrial, left ventricular size and EF in AF group and subgroup were separately compared with control group.Results:Systolic pressure,diastolic pressure, hematocrit, PLA, left ventricular size and EF didn't differ from AF group and control group, and so did between subgroups and control group. But plasma fibrinogen were higher in AF group and subgroups than in control group, and there were significantly different in the Levels of D-dimer and left atrial size in AF group and subgroups (persistent and permanent AF) compared with the control group. Positive significant linear correlations were found between fibrinogen and left atrial volume.Conclusions: Prothrombotic state is existed in non-valvular atrial fibrillation, and there are a positive correlation between fibrinogen and left atrial size.